The American College of Physicians (ACP) released new clinical advice that aims to reduce over screening for cervical cancer in average risk women without symptoms.
The news advice suggests women should undergo cervical cancer screening every three years with cytology tests alone starting at the age of 21.
"ACP's advice for cervical cancer screening is designed to maximize the benefits and minimize the harms of testing," said Dr. David Fleming, president of ACP. "Historically, physicians have low adherence to cervical cancer screening recommendations, beginning screening too early, performing screening too often, and continuing to screen women at low risk, either by age criteria or after hysterectomy with removal of cervix."
The screening guidelines also suggest physicians should use a combination of cytology and HPV (human papillomavirus) testing every five years in average risk women over the age 30 who prefer less frequent screenings. Physicians are advised stop screening average risk women older than 65 years who have had three consecutive negative cytology results or two consecutive negative cytology plus HPV test results within a decade.
The ACP does not advice that women younger than 21 should be screened for cervical cancer, perform HPV testing in average risk women younger than 30 years, or screen average risk women of any age for cervical cancer if they have undergone a hysterectomy with removal of the cervix.
Negative side effects that can come with unnecessary cervical cancer screening include: "discomfort with speculum examinations and colposcopies, pain and bleeding with cervical biopsies and excisional treatments, prolonged surveillance, potential adverse obstetrical outcomes with some excisional treatments, and false positive testing," the ACP reported.
"By following ACP's Best Practice Advice, physicians can practice high value care by reducing over-screening, overtreatment, and unnecessarily higher costs," said Dr. George F. Sawaya of the University of California, San Francisco Center for Healthcare Value.
The guidelines were published in a recent edition of the journal Annals of Internal Medicine.
