Screening for Cervical Cancer: US Preventive Services Task Force Recommendation Statement

By U. P. S. T. Force, Susan J. Curry, A. Krist, Douglas K. Owens, Michael J. Barry, Aaron B. Caughey, Karina W. Davidson, Chyke A Doubeni, J. Epling, Alex R. Kemper and 8 more. Journal of the American Medical Association (JAMA), 2018

1,287 citations recorded by the source corpus.

Importance The number of deaths from cervical cancer in the United States has decreased substantially since the implementation of widespread cervical cancer screening and has declined from 2.8 to 2.3 deaths per 100 000 women from 2000 to 2015. Objective To update the US Preventive Services Task Force (USPSTF) 2012 recommendation on screening for cervical cancer. Evidence Review The USPSTF reviewed the evidence on screening for cervical cancer, with a focus on clinical trials and cohort studies that evaluated screening with high-risk human papillomavirus (hrHPV) testing alone or hrHPV and cytology together (cotesting) compared with cervical cytology alone. The USPSTF also commissioned a decision analysis model to evaluate the age at which to begin and end screening, the optimal interval for screening, the effectiveness of different screening strategies, and related benefits and harms of different screening strategies. Findings Screening with cervical cytology alone, primary hrHPV testing alone, or cotesting can detect high-grade precancerous cervical lesions and cervical cancer. Screening women aged 21 to 65 years substantially reduces cervical cancer incidence and mortality. The harms of screening for cervical cancer in women aged 30 to 65 years are moderate. The USPSTF concludes with high certainty that the benefits of screening every 3 years with cytology alone in women aged 21 to 29 years substantially outweigh the harms. The USPSTF concludes with high certainty that the benefits of screening every 3 years with cytology alone, every 5 years with hrHPV testing alone, or every 5 years with both tests (cotesting) in women aged 30 to 65 years outweigh the harms. Screening women older than 65 years who have had adequate prior screening and women younger than 21 years does not provide significant benefit. Screening women who have had a hysterectomy with removal of the cervix for indications other than a high-grade precancerous lesion or cervical cancer provides no benefit. The USPSTF concludes with moderate to high certainty that screening women older than 65 years who have had adequate prior screening and are not otherwise at high risk for cervical cancer, screening women younger than 21 years, and screening women who have had a hysterectomy with removal of the cervix for indications other than a high-grade precancerous lesion or cervical cancer does not result in a positive net benefit. Conclusions and Recommendation The USPSTF recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years. (A recommendation) The USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with hrHPV testing alone, or every 5 years with hrHPV testing in combination with cytology (cotesting) in women aged 30 to 65 years. (A recommendation) The USPSTF recommends against screening for cervical cancer in women younger than 21 years. (D recommendation) The USPSTF recommends against screening for cervical cancer in women older than 65 years who have had adequate prior screening and are not otherwise at high risk for cervical cancer. (D recommendation) The USPSTF recommends against screening for cervical cancer in women who have had a hysterectomy with removal of the cervix and do not have a history of a high-grade precancerous lesion or cervical cancer. (D recommendation)

Subfields: Epidemiology, Microbiology, Oncology

View Paper: https://www.semanticscholar.org/paper/6aafeffbd5f3b4c8268036e409227247fe5ee4e8

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Epidemiology

1. R. Siegel
2. K. Miller
3. A. Jemal

In Oncology

1. R. Siegel
2. A. Jemal
3. K. Miller
4. S. Fedewa
5. Jiemin Ma
6. F. Bray
7. Balázs Győrffy
8. J. Ferlay

Citations in the corpus

• Annual Report to the Nation on the Status of Cancer, 1975–2012, Featuring the Increasing Incidence of Liver Cancer (2016, neutral): “Much of the morbidity and mortality associated with cancer can be prevented by detecting the disease at an early stage, when treatment is more effective.(30,57,111,112) On the basis of systematic reviews of the net benefits and harms of screening, the USPSTF currently recommends population-based scr”
• Colorectal Cancer Incidence Patterns in the United States, 1974–2013 (2017, background): “Yet it is worth noting that in 2013 there were about 10 400 new CRCs diagnosed in adults age 40 to 49 years and 12 800 cases in adults age 50 to 54 years, similar to the total number of cervical cancers (12 300) (51), for which screening of 95 million women age 21 to 65 years is recommended (52).”