From the Guidelines
After a patient has a colposcopy and a subsequent negative Pap test and negative HPV test one year later, she can generally return to routine cervical cancer screening, with the recommended interval being every 5 years if co-testing with HPV is performed, or every 3 years with Pap test alone, as per the guidelines from the American Cancer Society 1. The specific interval depends on the patient's age and risk factors. Women under 21 typically don't need screening, while those over 65 with adequate prior negative screening may discontinue testing altogether.
- The negative follow-up results indicate that the initial abnormality that prompted the colposcopy has resolved, and the absence of high-risk HPV suggests a very low risk of developing significant cervical abnormalities in the near future.
- However, it's essential to note that individual recommendations may vary based on the severity of the initial abnormality, the findings at colposcopy, the patient's medical history, and other risk factors.
- The patient should discuss her specific situation with her healthcare provider to determine the most appropriate screening interval for her circumstances, considering the guidelines from the American Cancer Society 1 and the American Society for Colposcopy and Cervical Pathology 1.
- A study published in 2021 1 provides guidance on the management of abnormal cervical cancer screening tests and cancer precursors, which can help inform the decision-making process for the patient's screening interval.
- Additionally, a study from 2013 1 reviews the current American Cancer Society guidelines for cervical cancer screening, which also supports the recommended screening intervals.
From the Research
Screening Guidelines
- The American Society of Colposcopy and Cervical Pathology management guidelines recommend that patients with a negative human papillomavirus (HPV) test and a satisfactory Papanicolaou (Pap) test undergo repeat age-based screening in 3 to 5 years 2.
- However, for patients who have had a colposcopy and a repeat Pap test in one year that is negative for cellular changes and HPV negative, the guidelines are not explicitly stated in the provided studies.
- A study published in the American journal of clinical pathology in 2023 suggests that women with an unsatisfactory Pap test and negative HPV cotest may be safely called back at an interval longer than 4 months 2.
- Another study published in the American journal of obstetrics and gynecology in 2021 found that women who tested negative for HPV had the lowest 1-year cumulative risk for cervical intraepithelial neoplasia grade 3 or worse (0.06%) 3.
Screening Intervals
- The screening interval for women with a negative HPV test and a satisfactory Pap test is generally 3 to 5 years 2.
- However, the optimal screening interval for women who have had a colposcopy and a repeat Pap test in one year that is negative for cellular changes and HPV negative is not clearly established in the provided studies.
- A study published in the Acta cytologica in 2000 found that the combination of Pap smear, cervicography, and HPV DNA testing was more sensitive in detecting cervical intraepithelial neoplasia (CIN) 2 and 3 than Pap smear alone, but the screening interval was not addressed 4.
- Another study published in the CytoJournal in 2010 found that patients with persistent inflammatory Pap smears can harbor a high proportion of CIN and may require further evaluation, but the screening interval was not specified 5.
HPV Testing
- HPV testing is an important tool in cervical cancer screening, and a negative HPV test result is associated with a low risk of cervical intraepithelial neoplasia grade 3 or worse 3.
- A study published in the Anticancer research in 2005 compared different screening tools, including HPV testing, and found that HPV testing was a useful tool in detecting CIN 2 and 3, but the screening interval was not addressed 6.