The US Preventive Services Task Force (USPSTF) has released a new draft recommendation suggesting that high-risk human papillomavirus (HPV) testing every five years should be the preferred method for cervical cancer screening in women aged 30 to 65. The updated guideline highlights HPV testing as the most effective screening strategy for detecting cervical cancer.
HPV Testing as the Primary Screening Tool
For decades, cervical cancer screening relied primarily on Pap smears, or cervical cytology, where cells from the cervix are collected and examined for cancerous or precancerous changes. The new recommendation, however, places greater emphasis on HPV testing, given that most cervical cancers are caused by high-risk HPV strains. The HPV test involves collecting a vaginal sample to check for infection with high-risk types of the virus that can lead to cervical cancer.
Dr. Esa Davis, a member of the USPSTF and a professor at the University of Maryland, explained that HPV testing strikes the best balance between benefits and potential harms in detecting cervical cancer. She noted that it should be offered as the first choice for women in this age group whenever available.
Self-Collection for HPV Testing
For the first time, the recommendation also introduces the option for women to self-collect vaginal samples for HPV testing. This approach aims to improve accessibility for individuals who may avoid traditional screenings due to discomfort or logistical challenges.
The self-collection method allows patients to gather their own samples in a healthcare setting, such as a doctor’s office, urgent care center, or mobile clinic. This option could be especially appealing to women who are uncomfortable with clinician-collected screenings, encouraging broader participation in cervical cancer screening programs.
Dr. Davis highlighted that self-collection can expand access and help reach women who might not otherwise come in for screening. Early detection remains critical, as cervical cancer is highly preventable and treatable when identified in its early stages.
Alternative Screening Methods
When HPV testing is not available, the USPSTF still recommends other effective screening options, including Pap smears every three years or co-testing (a combination of Pap smears and HPV testing) every five years. These alternatives remain valid choices for both clinicians and patients, but HPV testing alone is now considered the most effective strategy.
The task force clarified that the shift toward HPV testing does not imply that Pap smears are harmful, but rather that HPV testing is a more effective screening tool for women aged 30 to 65.
Recommendations for Younger and Older Women
For women aged 21 to 29, the USPSTF continues to recommend screening with cervical cytology alone every three years. Screening is not advised for women under 21, as cervical cancer is rare in this age group, and most HPV infections are clear on their own. Similarly, women over 65 who have had adequate prior screenings and are not at high risk are not recommended for continued screening.
The draft recommendation builds on the task force’s 2018 guidelines, which provided multiple screening options for women aged 30 to 65. The latest updates aim to streamline recommendations while incorporating new options like self-collected HPV tests.
Preventing Cervical Cancer Through Early Detection
HPV is a group of more than 150 viruses, some of which are classified as high-risk due to their association with cancers such as cervical, anal, penile, and oropharyngeal cancers. While most HPV infections resolve naturally within two years, persistent infections with high-risk strains can lead to serious health issues, including cervical cancer.
The American Cancer Society also supports HPV testing as part of a comprehensive cervical cancer screening strategy. The organization emphasizes that primary HPV testing is more effective at preventing cervical cancer than Pap tests alone.
Regular screening is vital for women aged 21 to 65, as cervical cancer is one of the most preventable and treatable forms of cancer. The introduction of self-collection options may further improve screening rates by addressing barriers that prevent some women from seeking care.
Expanding Access and Reducing Barriers
In May, the US Food and Drug Administration approved the use of self-collected vaginal samples for two HPV tests. This allows patients to collect their samples in a healthcare setting, providing a more comfortable and accessible option for screening.
By reducing barriers to screening, the USPSTF hopes to encourage more women to participate in regular screenings, ultimately reducing the incidence and mortality associated with cervical cancer.
The draft recommendation is available for public comment through January 13 and will be finalized after considering feedback. For now, the focus remains on ensuring that women have access to effective and accessible screening options, with HPV testing at the forefront of cervical cancer prevention efforts.
