Skip to main navigation
Skip notifications
Access to POEMs and Essential Evidence Plus will no longer be included in CMA membership as of Dec. 1, 2023.
Search
USPSTF 2018: HPV testing alone every 5 years is acceptable screening in women 30 to 65 years old (A recommendation)
Clinical Question
What are the optimal methods to screen women, aged 30 to 65 years, for cervical cancer?
Bottom line
In this updated 2018 review, The US Preventive Services Task Force concludes that screening every 3 years with cervical cytology alone, every 5 years with HPV testing alone, or every 5 years with HPV testing in combination with cytology (co-testing) is acceptable for women aged 30 to 65 years (A recommendation). This recommendation does not apply to women with in utero exposure to diethylstilbestrol, a previous diagnosis of high-grade precancerous cervical lesions or cervical cancer, or who have a compromised immune system (eg, women living with HIV). The major change from the 2012 recommendation is that screening every 5 years with HPV testing alone is an acceptable alternative strategy. 2c
Reference
Study design: Practice guideline
Funding: Government
Setting: Population-based
Synopsis
In this 2018 version, the task force found updated evidence from randomized clinical trials, cohort studies, and decision modeling studies that screening with cytology alone is less sensitive for detecting precancerous CIN 2 and CIN 3 than screening with HPV testing alone or in combination with cytology (co-testing). However, HPV testing alone and co-testing have higher false-positive rates compared with cytology alone, with co-testing having the highest false-positive rate. Screening more frequently does not improve benefit, but significantly increases the number of screening tests and colposcopies. Most clinicians currently recommend co-testing every 5 years for women aged 30 to 65 years, but this updated evidence demonstrates that HPV testing alone is equally sensitive as co-testing and results in fewer unnecessary follow-up tests and colposcopies. The American Academy of Family Physicians and the American College of Obstetricians and Gynecologists also suggest that primary HPV screening alone can be considered an alternative strategy in women 30 years or older.
Reviewer
David C. Slawson, MD
Professor and Vice Chair of Family Medicine for Education and Scholarship
Atrium Health
Professor of Family Medicine, UNC Chapel Hill
Charlotte, NC
Comments
good poem
This analysis is very helpful.What is the advice for 15_30 year olds
Is there any information re testing males
I think current screening guidelines are causing us to miss cervical cancers. I am seeing advanced ca in people that I never saw before the changes in guidelines.
great, so holding pap test for future generation ?
I would support not only HPV screening but also HPV self testing as an option for women over 30 years in Canada as a screening method.
Excellent
Et que fait-on de celles qui ont été vaccinées?