Cervical Cancer screening in average-risk women: Best practice advice from the clinical guidelines committee of the American College of Physicians

Description: The purpose of this best practice advice article is to describe the indications for screening for cervical cancer in asymptomatic, average-risk women aged 21 years or older. Methods: The evidence reviewed in this work is a distillation of relevant publications (including systematic reviews) used to support current guidelines. Best Practice Advice 1: Clinicians should not screen averagerisk women younger than 21 years for cervical cancer. Best Practice Advice 2: Clinicians should start screening average-risk women for cervical cancer at age 21 years once every 3 years with cytology (cytologic tests without human papillomavirus [HPV] tests). Best Practice Advice 3: Clinicians should not screen averagerisk women for cervical cancer with cytology more often than once every 3 years. Best Practice Advice 4: Clinicians may use a combination of cytology and HPV testing once every 5 years in average-risk women aged 30 years or older who prefer screening less often than every 3 years. Best Practice Advice 5: Clinicians should not perform HPV testing in average-risk women younger than 30 years. Best Practice Advice 6: Clinicians should stop screening average-risk women older than 65 years for cervical cancer if they have had 3 consecutive negative cytology results or 2 consecutive negative cytology plus HPV test results within 10 years, with the most recent test performed within 5 years. Best Practice Advice 7: Clinicians should not screen averagerisk women of any age for cervical cancer if they have had a hysterectomy with removal of the cervix.