From the Guidelines
Pap screening for HPV should be performed every 5 years with the combination of HPV testing and cytology (“cotesting”) for women aged 30 to 65 years, as this approach improves detection sensitivity compared to Pap testing alone. This recommendation is based on the guidelines issued by the American Cancer Society, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology (ASCP) in 2012, as well as the U.S. Preventive Services Task Force (USPSTF) recommendations 1. For women aged 21 to 29 years, Pap tests alone every 3 years are recommended, as HPV testing is not routinely recommended for this age group due to the high prevalence and transient nature of HPV infections in younger women. Some key points to consider when implementing Pap screening for HPV include:
- Screening for cervical cancer should begin at age 21 years, with women under 21 not being screened regardless of their age of sexual initiation 1.
- Women should discontinue screening after age 65 years if they have had 3 consecutive negative cytology tests or 2 consecutive negative cotest results within the 10-year period prior to ceasing screening, with the most recent test occurring within the last 5 years 1.
- Annual screening by any method is not recommended for women at any age 1. The HPV test identifies high-risk HPV types that are associated with cervical cancer development, and co-testing with both a Pap smear and an HPV DNA test can help improve detection sensitivity and guide follow-up care.