USPSTF vs Pap Smears

So, did you hear the latest from the US Preventive Services Task Force?  No, not regarding vitamin D.  And no, not regarding screening for prostate cancer w/PSA.  Rather, I'm referring to the update of their 2003 recommendations regarding screening for cervical cancer published, two weeks ago in the Annals of Internal Medicine.

First, we always want to review to whom these recommendations apply.  In this instance, USPSTF is addressing women w/cervix regardless of sexual history who have not had a high-grade precancerous cervical lesion or cervical cancer, been exposed to diethylstilbestrol, or are immunocompromised.

For this very specific group, USPSTF recommends screening for cervical cancer in women aged 21 to 65 years with cytology (Pap smear) every 3 years.  Women who are 30 to 65yo may opt for a combination of Pap smear and human papilloma virus (HPV) testing every 5 years.  On the other hand, HPV testing should not be used in those younger than 30yo.

What came out as a bit of a surprise was that USPSTF recommends against Pap smears for women younger than 21yo and those older than 65yo who've had adequate prior screening and are otherwise at low risk.

What hasn't changed is that USPSTF continues to recommend against Pap smears for women who've had a total hysterectomy (referring to removal of cervix, not ovaries) AND don't have a history of high-grade precancerous cervical lesion or cervical cancer.

Bottom line: know your guidelines, know your groups.

The times, they are a-changin'.
-Bob Dylan

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