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Testing for high-risk human papillomaviruses every five years—in A A self-collected sample – starting at age 30 – is the “screening method of choice” for cervical cancer, according to a new draft recommendation from the US Preventive Services Task Force.
Typically, many women have cervical cancer – also known as cervical cytology. Pap tests or Pap smears – Where cells are collected from the cervix and checked for signs of cancer.
But a draft of the USPSTF recommendation released Tuesday emphasizes that testing for high-risk human papillomavirus, or HPV, should be the primary screening method for women ages 30 to 65. Cervical cancer They are caused by a virus. HPV testing involves collecting a sample of the vagina and testing for cells with high-risk types of HPV that can cause cervical cancer.
“As a first-line screening for women between the ages of 30 and 65, we are suggesting that HPV testing is the best balance of benefits and harms in detecting cervical cancer and should be offered early and when detected,” he said. Task Force Member Dr. Isa DavisProfessor and Senior Associate Dean of Public Health and Community Medicine at the University of Maryland in Baltimore.
And for the first time, the draft proposal includes the option for women to self-collect their own vaginal samples for HPV testing.
“Now we have an additional screening challenge that is more attractive to those who don't come for screening, and that's with self-collection,” Davis said.
When HPV testing is not available, a screening Pap test or both HPV testing and cervical cytology is recommended.
HPV testing “has the better balance of benefits and harms, but the other two are effective screening options, so they will still be the choice for clinicians and patients,” Davis said.
This amendment to the draft recommendation is not because the Pap test is harmful, but because the HPV test is more effective as a cervical cancer screening tool for ages 30 to 65, according to the task force. The draft recommendation continues to recommend that women in their 20s undergo cervical cytology screening every three years.
The draft recommendation is not final, but is available at Task force website For public comment until January 13, with a review of draft evidence, as USPSTFA group of independent medical professionals who help guide physicians' decisions and influence insurance plans.
of The American Cancer Society also recommends HPV testing. As part of the cervical cancer screening program, the organization states on its website that primary HPV testing is better than Pap testing alone in preventing cervical cancer.
“We look forward to providing these important guidelines for cervical cancer screening and providing feedback to the USPSTF,” said Dr. Robert Smith, senior vice president of science for early cancer screening at the American Cancer Society, in a statement. “Since cervical cancer is one of the most preventable and treatable types of cancer, screening guidelines are very important for women, and it is very important for women to be screened regularly.”
It is assumed that 80% of people get HPV infection During their lifetime.
HPV, a A group of more than 150 virusesIt is primarily sexually transmitted, with low-risk varieties that usually cause warts and high-risk varieties that include cancers such as cervical, rectal, genital, and oropharyngeal cancer.
If a woman is diagnosed with high-risk HPV, it does not necessarily mean she has cancer. In most cases, HPV will disappear on its own within two years, however When the infection does not go awayHealth problems such as cancer can occur – which is why it helps to identify and monitor these infections in time.
When finalized, the draft proposal will update the USPSTF's latest. Cervical cancer screening adviceIn the year In 2018, the task force recommended screening only cervical cytology in women aged 21 to 29 every three years. It recommends three options for women aged 30 to 65: continue screening every three years with cervical cytology alone; Only high-risk human papillomavirus testing every five years; or every five years with high-risk HPV testing in combination with cytology.
The task force recommends against cervical cancer screening for women younger than 21 and women older than 65 who have had adequate early screening and are not at high risk for cervical cancer — and the new draft recommendation continues that guidance.
Overall, “if you're between the ages of 21 and 65, regular screening is very important, because cervical cancer is highly preventable and treatable, and early detection is critical,” Davis said, adding the introduction. In the new draft recommendation, self-collection HPV tests could help expand access to screening.
In May, the US Food and Drug Administration It has expanded the approval of two HPV tests. Allowing self-collected vaginal specimens to be used with those tests when a patient is unable or does not choose to have them collected by a health care professional.
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With this FDA green light, patients have the option to collect their own vaginal samples for testing whether self-collection occurs in a healthcare setting such as their doctor's office, urgent care or mobile clinic. The approach is similar to how patients collect a urine sample themselves when they visit their doctor.
“This self-collection option provides greater access to women who feel more comfortable doing those self-collections, thereby expanding the opportunity to screen more women who may not be screened,” Davis said.
“For those who didn't feel comfortable going in before, here's the option now, which appeals to the team and gets them to come in for screening, because cervical cancer is preventable if it's detected early,” she said. We don't want any barriers for women who are eligible to get tested.