Screening Recommendations for Cervical Cancer Affect Menopausal Women

Patient Expert

It's one of those cancers that can sneak up on you. In fact, 12,000 women in the United States are diagnosed annually with cervical cancer. And sadly, about 4,000 women die from this cancer each year.

Cervical cancer, which forms in the tissues of the cervix that connect the uterus and vagina, is frequently caused by the genital human papillomavirus (HPV) infection. While this infection is common and usually resolves itself, persistent infections can cause the cervical cells to mutate into a form that may turn into slow-growing cervical cancer. And what makes this form especially difficult is that the symptoms often are not seen until later in the disease so when it's found, it's in a later stage.

That's why it's important to be tested regularly for cervical cancer. There are two tests for the disease. The first is the Pap test, which analyzes the cells for changes that may become cancerous. The second is the HPV test, which looks for the types of HPV infection that are most likely to cause cancer.

Therefore, I want to alert you to new screening guidelines from the American Congress of Obstetricians and Gynecologists. The group's most recent recommendations for women who are middle-age or older are as follows:

  • Women who are between the ages of 30-65 should have a Pap test and an HPV test at the same time every five years. However, the ACOG also said it is acceptable to have a Pap test alone every three years.
  • After the age of 65, women should stop being screened for cervical cancer if they don't have a history of moderate or severe dysplasia (abnormal cells found on the surface of the cervix) or cancer, and if they have had either three negative Pap test results in a row or two negative co-test results in a row within the past 10 years. The most recent test needs to have been performed within the past five years.
  • However, these routine guidelines don't apply to women who have a history of cervical cancer, who have the human immunodeficiency virus (HIV), who have a weakened immune system, or who were exposed to diethylstilbestrol (DES) before they were born.

The ACOG changed the guidelines because researchers during the past decades have not found an overall advantage for women to have an annual Pap test instead of a screening every three years. "Yearly Pap tests do find a slightly higher number of cancer cases than tests performed every 3 years," the ACOG stated. "However, women who have yearly screening undergo many more follow-up tests for what turns out not to be cancer than women who have 3-year test." However, women who have had a hysterectomy may need to still have a cervical cancer screening. This will depend on whether the cervix was removed, why the hysterectomy was done and if you have a history of moderate or severe dysplasia. The ACOG does recommend a yearly well-woman check-up.

Additionally, the Centers for Disease Control and Prevention surveyed doctors and women between 2009-2010 about the co-test of the Pap test and the HPV test. The responses indicated that only 39 percent of health care providers regularly used the co-test and 25 percent would recommend testing at the recommended interval for women who had normal results on these screenings. The doctors were worried about patients not returning annually for other screening tests, liability and concerns by patients that the diagnosis of cancer would be missed. The CDC study also found that patients had low levels of knowledge about the Pap test.

So what does this all mean for you? I'd encourage you to learn about both the Pap test and the HPV test and then talk to your doctor about these screenings. Together, you should come up with a plan that is tailored for your situation.

Primary Sources for This Sharepost:

American Cancer Society. (2014). Signs and symptoms of cervical cancer.
American Congress of Obstetricians and Gynecologists. (2013). New guidelines for cervical cancer screening.
Centers for Disease Control and Prevention. (2014). CDC's cervical cancer study.
National Cancer Institute. (ND). Cervical cancer.