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The new US preventive service task force USPSTF guidelines recommend that women ages 21 to 29 years be screened for cervical cancer every three years with the Pap test alone. This recommendation remains unchanged from 2012. For women ages 30 to 65 years, the USPSTF recommends screening for cervical cancer with primary high-risk human papillomavirus (hrHPV) test alone every five years.
Women ages 30 to 65 years were given the option for to be screened with hrHPV test and Pap test together every five years to lengthen their screening interval. The 2018 recommendations go one step further by including, for the first time, the option of hrHPV testing alone, without a Pap test, every five years.
Co-testing is slightly better than primary hrHPV testing at detecting precancerous lesions but is associated with increased tests and diagnostic procedures that may not benefit the patient and have real costs to the health care system. Pap tests detect changes in cervical cells that could indicate the presence of pre-cancer or cancer, while HPV tests detect the genetic material or DNA of the high-risk types in cervical samples.
The new recommendations come with new demands on patients, especially those who bear the greatest disease burden from cervical cancer: women from low socioeconomic backgrounds, women from communities of color, and other women with compromised access to timely and effective care. Nearly all cases of cervical cancer are caused by infection with oncogenic, or high-risk, types of HPV. Cervical cancer is the fourth most common cancer in women worldwide.