U.S. Preventive Services Task Force: Cervical Cancer Screening Guidelines

U.S. Preventive Services Task Force: Cervical Cancer Screening Guidelines

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It is estimated that roughly 12,000 U.S. women are diagnosed with cervical cancer annually and a third of them die from it. HPV is a sexually-transmitted virus and is the most common cause of such cervical cancer.

The U.S. Preventive Services Task Force (USPSTF) recently published draft cervical cancer screening guidelines. For a quick reference, here are some of the findings:

  • The USPSTF recommends screening for cervical cancer with cytology (Papanicolaou [Pap] smear) every 3 years in women ages 21 to 65 years who have had vaginal intercourse and have a cervix.
  • The USPSTF recommends against screening for cervical cancer in women younger than age 21 years, regardless of sexual history.
  • The USPSTF recommends against screening for cervical cancer in women older than age 65 years who have had adequate prior screening and are not otherwise at high risk for cervical cancer.
  • The USPSTF recommends against screening for cervical cancer in women who have had a total hysterectomy for benign disease.
  • The USPSTF recommends against screening for cervical cancer using human papillomavirus (HPV) testing, alone or in combination with cytology, in women younger than age 30 years.
  • The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of HPV testing, alone or in combination with cytology, for screening for cervical cancer in women ages 30 years and older.

Current USPSTF guidelines recommend screening of sexually active women with a cervix.  Those guidelines reflect the sound premise that sexual activity puts women at risk of cervical cancer, despite the sex of sexual partners.

The current draft recommendations disregard the sound science that demonstrates risk to communities of women who have sex with women (WSW).  It is well established that WSW, including those that have no history of vaginal intercourse with men, are susceptible to genital HPV infection and cervical neoplasia.  This has been demonstrated with the detection of HPV DNA, including HPV 6 and 16, among genital samples obtained from WSW with no prior history of sex with men.

Data suggest that WSW do not receive adequate preventive health encounters, including Pap smear screening.  Earlier this year, the National Institutes of Health asked the Institute of Medicine to evaluate the current status of LGBT health and to identify research opportunities and gaps.  Inadequate preventive health, including cervical cancer screening for WSW, remains a national priority.

The full report can be accessed here.

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