Cervical Cancer Screening Guidelines

March 16,2022
1 Min Read

To eliminate cervical cancer, all countries must reach and maintain an incidence rate of below 4 per 1,00,000 women by 2030.

This depends on 3 key pillars and corresponding targets:

Vaccination: 90% of girls are fully vaccinated with the HPV vaccine by the age of 15 years.
Screening: 70% of women screened using a high-performance test by the age of 35 years, and again by the age of 45 years.
Treatment: 90% of women with pre-cancer treated and 90% of women with invasive cancer managed.

Cervical Cancer Screening Guidelines

	ACOG 2021 Guidelines	FOGSI 2018 Guidelines
Cytology alone	21-65 years: Every 3 years	25-65 years: Every 3 years
HPV testing alone	21-29 years: Not recommended 30-65 years: Every 5 years	25-65 years: Every 5 years
Co-testing	21-29 years: Not recommended 30-65 years: Every 5 years	25-65 years: Every 5 years
Criteria to stop screening	Women over 65 years of age with previous adequate negative prior screening* and no history of CIN2+. Women with no prior screening should undergo tests once at 65 years and, if negative, they should exit screening.	Women over 65 years of age with previous adequate negative screening* and no history of CIN2+ within the last 20 years.
Women with history of hysterectomy	No screening for cervical cancer in women who have had a hysterectomy with the removal of the cervix, unless they have a history of CIN2+ lesions or cervical cancer.	In women who have undergone hysterectomy for benign reasons, screening is not advised. In women who have undergone hysterectomy with a report of CIN2+ lesions, screening should be continued for 20 years from the age of surgery.
Post-vaccination	Women who have received the HPV vaccine should be screened according to the same guidelines as women who have not been vaccinated.

*Adequate negative prior screening results are defined as 3 consecutive negative cytology results or 2 consecutive negative co-test results within the previous 10 years, with the most recent test performed within the past 5 years.

Co-testing or HPV DNA testing SHOULD be the preferred method of screening. Doing a PAP LBC by itself is not enough.

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