Cervical Cancer Screening Should Start at a Later Age: Report

A health care task force recommends screening for cervical cancer at a later age than previously deemed necessary for women.

In a report published this week, the Canadian Task Force on Preventive Health Care (CTFPHC) says that while regular screening has reduced both the occurrence and incidents of death due to cervical cancer in Canada, early and frequent (i.e. annual) screening is not necessary.

This is the first time since 1994 that the guidelines have been updated. The CTFPHC is an independent panel of clinicians and methodologists who develop clinical practice guidelines for preventive health. 

The new guidelines say screening should start at the age of 25 as the disease is rare in the younger age groups, and should occur every 3 years.

In coming up with the recommendations, the CTFPHC made no considerations for cost-effectiveness. Instead, the task force considered global best practices as well as balancing benefits of screening with the potential harms that it may introduce. 

According to the CTFPHC, screening every three years provides 80 to 90 percent protection against cervical cancer, while screening more frequently offers little additional benefit. 

“[O]ther countries have achieved similar outcomes with less frequent testing and starting screening at older ages,” the report said.

The task force also recommends that screening cease for women aged 70 and above whose tests have been negative for the past 10 years. 

The use of the Pap test for screening is still recommended, as the use of HPV testing as a screening method is not yet proven. 

The CTFPHC’s recommendations apply to women with no symptoms of cervical cancer and no previous abnormal screening results and who are or have been sexually active. They do not apply to women who do not have a cervix due to hysterectomy or who are immunosuppressed. 

There were an estimated 1,3000 new cases of cervical cancer and about 350 deaths in 2011, according to the CTFPHC. The number of cases of the disease and mortality caused by it has decreased significantly in the past 50 years. 

The CTFPHC report was published in the Canadian Medical Association Journal.

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