This article and audio describe important recent changes in cervical cancer screening recommended by the American College of Gynecology in 11/2009.

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Screening in the recent news – Prostate cancer, Breast cancer, Cervical cancer

• Controversy about what age groups and how often
• There is significant disagreement among experts

For screening to be effective

• It must be sensitive — The test(s) should pick up all cases of disease (There should be minimal false negatives)
• It must also be specific — The test(s) should not indicate presence of disease that is not present (There should be minimal false positives)
• There must be effective and safe treatments

Cervical Cancer Incidence

• Rates have fallen more than 50 % in the last 30 years – due to Pap smears
• 11,270 new cases of cervical cancer and 4,070 deaths from it in the US projected in 2009
• Estimates by the American Cancer Society
• This is mainly in women who have had inadequate or no screening

Cervical Cancer Screening — Significant changes recommended by American College of Gynecology

• Start screening at 21 years of age
• Much of the dysplasia in adolescents is caused by HPV but this clears frequently on its own
• Pap smears every 2 years between 21 and 30 years of age
• In 30 year + age group with 3 negative Pap screenings frequency should  be every 3 years
• No further screening in women 65 years or older who have had 10 years of negative screenings
• Women at high risk require individual screening plans

High Risk Populations

• HPV infection
• Smoking
• Immunosuppresion
• Oral contraceptives
• Poverty
• Diethylstibestrol (DES) exposure in utero
• Family history of cervical cancer

Cervical cancer and dysplasia

• Cervical cancer is a slow growing cancer.
• Cervical cancer and dysplasia are caused by certain strains of human papilloma virus(HPV).
• Many of the abnormalities found on Pap smear if left alone would resolve on their own.