Cervical Cancer Screening

Abstract

Globally, cervical cancer is the fourth most common cancer in women and other people with a cervix. Population-based screening, applied to asymptomatic average-risk individuals, remains the core of prevention and focuses on the risk of high-grade cervical precancers and cancers. In the United States, underscreening is associated with socioeconomic disparities. Screening strategies include cytology alone, cotesting, and primary human papillomavirus (HPV) screening. The American Cancer Society recommends initiating cervical cancer screening at 25 years of age; primary HPV testing every 5 years is the preferred method. The US Preventive Services Task Force 2024 draft recommendation endorses the use of primary HPV screening every 5 years as the preferred method beginning at 30 years of age and recommends cytology alone every 3 years in patients 21 to 29 years of age. Cytology alone and cotesting are acceptable screening methods. Conclusion of screening at 65 years of age is recommended for individuals without a history of high-grade cervical intraepithelial neoplasia or cervical cancer in the past 25 years and with adequate negative screening results at 60 and 65 years of age. Management of patients with abnormal cervical cancer screening results should follow the 2019 American Society for Colposcopy and Cervical Pathology (ASCCP) risk-based management consensus guidelines.