cervical cancer screening guidelines 2020

Discuss follow‐up care for BC3NP clients according to the 2019 ASCCP Cervical Risk‐Based Management Guidelines 2. In the new recommendation, primary HPV testing is preferred, and both cotesting and cytology alone are included as acceptable transitional screening strategies from age 25 years for all individuals. It cannot be stressed too emphatically that the updated ASCCP management guidelines should be regarded as integral to the success of this screening guideline, because failure to follow‐up a positive screening test in a manner that is adherent to the ASCCP management guidelines undermines what is achieved with screening and can result in harm to the patient. These new screening recommendations differ in 4 important respects compared with the 2012 recommendations: 1) The preferred screening strategy is primary HPV testing every 5 years, with cotesting and cytology alone acceptable where access to US Food and Drug Administration‐approved primary HPV testing is not yet available; 2) the recommended age to start screening is 25 years rather than 21 years; 3) primary HPV testing, as well as cotesting or cytology alone when primary testing is not available, is recommended starting at age 25 years rather than age 30 years; and 4) the guideline is transitional, ie, options for screening with cotesting or cytology alone are provided but should be phased out once full access to primary HPV testing for cervical cancer screening is available without barriers. ... SA, Manassaram-Baptiste D, Saslow D, Wender RC, Smith RA.   MR The ACS will collaborate with professional societies and other stakeholders to assist in supporting the transition to primary HPV testing for cervical cancer screening. The U.S. Preventive Services Task Force (USPSTF) recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29. This document outlines the role of Registered Nurses in Cervical Cancer Screening. An HPV test looks for infection with the human papillomavirus (HPV) types that are linked to cervical cancer. Phone: 301-857-7877 Since 2010, the ACS and other organizations68-70 have recommended that cervical cancer screening should begin at age 21 years (and no earlier), regardless of the age of first vaginal intercourse. The full, updated guideline was published online July 30, 2020 in CA: Cancer Journal for Clinicians. The prevalence of HPV infection is a function of both the incidence (soon after sexual initiation) and persistence of the infection.6 The highest incidence and prevalence of infection with hrHPV types generally is observed in women aged <25 years and decreases with age.73, 74 In younger women, the HPV incidence rate is relatively high, rates of persistence and progression are low, and regression of precursor abnormalities is high compared with older age groups.75-77 As previously discussed, the majority of infections do not persist or progress to precancer but appear to undergo natural regression in a relatively short period of time (<2 years).6, 78 Studies using large clinical data sets show near zero cancer risk, and the lowest detection of cervical precancerous abnormalities is observed in women aged <25 years.79-81, Observational studies have reported that screening women aged 21 to 24 years has little demonstrated benefit in reducing the incidence of invasive disease compared with screening women aged ≥25 years.82-87 A significant fraction of treatable lesions are expected to regress,88 leading to a potentially high rate of overtreatment and associated harms (including potential adverse obstetric outcomes), with follow‐up testing and treatment of cervical abnormalities detected in screen‐positive women in this age group.86, 89, In the supplemental modeling analysis (Table 4),44, 45 starting screening with primary HPV testing at age 25 years, compared with a screening strategy of cytology alone from age 21 years followed by switching to primary HPV testing at age 25 years, retained >99% of the life‐years gained, (64,193 vs 64,195, respectively) with fewer colposcopies (1775 vs 1826). . Moreover, there is a lack of empirical evidence examining outcomes associated with primary HPV screening or cotesting after age 65 years. Emerging role of HPV self‐sampling in cervical cancer screening for hard‐to‐reach women: focused literature review, Self‐sampling for human papillomavirus (HPV) testing: a systematic review and meta‐analysis, Introduction of molecular HPV testing as the primary technology in cervical cancer screening: acting on evidence to change the current paradigm, Human papillomavirus testing on self‐sampled cervicovaginal brushes: an effective alternative to protect nonresponders in cervical screening programs, The acceptability of self‐collected samples for HPV testing vs. the Pap test as alternatives in cervical cancer screening, Education efforts may contribute to wider acceptance of human papillomavirus self‐sampling, HPV screening for cervical cancer in rural India. 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