Pap and HPV Testing fact sheet, National Cancer Institute
Cervical cancer screening, which includes the Pap test and HPV testing, is an essential part of a woman’s routine health care because it can detect cancer or abnormalities that may lead to cancer of the cervix.
Current guidelines recommend that women should have a Pap test every 3 years beginning at age 21. These guidelines further recommend that women ages 30 to 65 should have HPV and Pap cotesting every 5 years or a Pap test alone every 3 years. Women with certain risk factors may need to have more frequent screening or to continue screening beyond age 65.
Women who have received the HPV vaccine still need regular cervical screening.
What causes cervical cancer?
What is cervical cancer screening?
How is cervical cancer screening done?
When should a woman begin cervical cancer screening, and how often should she be screened?
What are the benefits of Pap and HPV cotesting?
Can HPV testing be used alone for cervical cancer screening?
How are the results of cervical cancer screening tests reported?
What follow-up tests are done if cervical cancer screening results are abnormal?
How are cervical abnormalities treated?
Do women who have been vaccinated against HPV still need to be screened for cervical cancer?
What are the limitations of cervical cancer screening?
Cervical Cancer Risk for 330,000 Women Undergoing Concurrent HPV Testing and Cervical Cytology in Routine Clinical Practice at a Large Managed Care Organization, PMC3272857, Feb 6, 2012.
Screening for cervical cancer: U.S. Preventive Services Task Force recommendation statement, annals 1183214, 19 June 2012 .
American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer, PMC3801360, Mar 14, 2012.
A May 2014 study says the cervical cancer rates in black women and women in their 60s are understated because they include those who have had hysterectomies
Rates of cervical cancer are higher than previously reported, according to a May 2014 study, specifically among older women and black women.
BACKGROUND: Invasive cervical cancer is thought to decline in women over 65 years old, the age at which cessation of routine cervical cancer screening is recommended. However, national cervical cancer incidence rates do not account for the high prevalence of hysterectomy in the United States.
METHODS: Using estimates of hysterectomy prevalence from the Behavioral Risk Factor Surveillance System (BRFSS), hysterectomy-corrected age-standardized and age-specific incidence rates of cervical cancer were calculated from the Surveillance, Epidemiology, and End Results (SEER) 18 registry in the United States from 2000 to 2009. Trends in corrected cervical cancer incidence across age were analyzed using Joinpoint regression.
RESULTS: Unlike the relative decline in uncorrected rates, corrected rates continue to increase after age 35-39 (APC(CORRECTED) = 10.43) but at a slower rate than in 20-34 years (APC(CORRECTED) = 161.29). The highest corrected incidence was among 65- to 69-year-old women, with a rate of 27.4 cases per 100,000 women as opposed to the highest uncorrected rate of 15.6 cases per 100,000 aged 40 to 44 years. Correction for hysterectomy had the largest impact on older, black women given their high prevalence of hysterectomy.
CONCLUSIONS: Correction for hysterectomy resulted in higher age-specific cervical cancer incidence rates, a shift in the peak incidence to older women, and an increase in the disparity in cervical cancer incidence between black and white women. Given the high and nondeclining rate of cervical cancer in women over the age of 60 to 65 years, when women are eligible to exit screening, risk and screening guidelines for cervical cancer in older women may need to be reconsidered.
Sources and more information:
Rates of Cervical Cancer Are Underestimated, Study Says, Time, May 12, 2014.
Increased age and race-specific incidence of cervical cancer after correction for hysterectomy prevalence in the United States from 2000 to 2009, NCBI PMID: 24821088, 2014 Jul 1;120(13):2032-8. doi: 10.1002/cncr.28548. Epub 2014 May 12. Full study on ReadCube.