American Cancer Society Issues New Cervical Cancer Early Detection Guidelines

American Cancer Society
Thursday, 14 November 2002

The American Cancer Society, the nation's leading voluntary health agency, today issued new guidelines addressing when and how often women should get early detection tests for cervical cancer and precancer.

The new guidelines, published in the Nov./Dec. issue of CA: A Cancer Journal for Clinicians, were developed by an expert panel and will impact who should be screened, when and with what test.

Under the new recommendations, most women would begin cervical cancer screening later, have an option to stop at a certain age (70 years) and be exempt from screening entirely if they have had a hysterectomy.

"The new guidelines will have a major impact on the number of women who are over-screened and over-treated," said Mary A. Simmonds, MD, FACP, national volunteer president of the American Cancer Society. "Because most cervical precancers grow slowly, having a test every two to three years will find almost all cervical precancers and cancers while they can be removed or treated successfully.

"However," Dr. Simmonds added, " it is important to emphasize that the biggest gain in reducing cervical cancer incidence and mortality would be achieved by increasing screening rates among women who have not been screened or who have not been screened regularly.

The American Cancer Society estimates that 13,000 women will develop invasive cervical cancer this year, and 4,100 women will die of it.

The new guidelines are: (note: these are not the full guidelines but rather are a short summary)

• Cervical cancer screening should begin approximately three years after a woman begins having vaginal intercourse, but no later than 21 years of age.
• Cervical screening should be done every year with regular Pap tests or every two years using liquid-based Pap tests. At or after age 30, women who have had three normal test results in a row may get screened every two to three years. But a doctor may suggest getting the test more often if a woman has certain risk factors such as human immunodeficiency virus (HIV) infection or a weakened immune system.
• Women 70 years of age and older who have had three or more normal Pap test results and no abnormal results in the last 10 years may choose to stop cervical cancer screening.
• Screening after a total hysterectomy (with removal of the cervix) is not necessary unless the surgery was done as a treatment for cervical cancer or precancer. Some other special conditions may require continued screening. Women who have had a hysterectomy without removal of the cervix should continue cervical cancer screening at least until age 70.

There is also a promising new test for human papilloma virus (HPV), not yet approved for screening by the FDA, which may be useful in detecting early cervical cancer in women over 30 years of age. If the test is approved, it may be added to the guidelines.

The American Cancer Society worked closely with representatives of other government and healthcare organizations that have an interest in early detection of cervical cancer to develop consistent recommendations for women.

The Society will continue to work in collaboration with other organizations to promote and educate health care providers and the public about the new recommendations.

The American Cancer Society is the nationwide community-based voluntary health organization dedicated to eliminating cancer as a major health problem by preventing cancer, saving lives and diminishing suffering from cancer, through research, education, advocacy and service.

For more information, or to contact American Cancer Society, see their website at: www.cancer.org