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Cervical Screenings

Recommendations for Routine Cervical Cancer Screening
Population* Recommendation USPSTF Recommendation Grade
Aged less than 21 years No Screening D
Aged 21-29 years Cytology alone every 3 years A
Aged 30-65 years Any one of the following:
  • Cytology alone every 3 years
  • FDA-approved primary hrHPV testing alone every 5 years
  • Cotesting (hrHPV testing and cytology) every 5 years
Aged greater than 65 years No screening after adequate negative prior screening results D
Hysterectomy with removal of the cervix No screening in individuals who do not have a history of high-grade cervical precancerous lesions or cervical cancer D

*These recommendations apply to individuals with a cervix who do not have any signs or symptoms of cervical cancer, regardless of their sexual history or HPV vaccination status. These recommendations do not apply to individuals who are at high risk of the disease, such as those who have previously received a diagnosis of a high-grade precancerous cervical lesion. These recommendations also do not apply to individuals with in utero exposure to diethylstilbestrol or those who have a compromised immune system (eg, individuals with human immunodeficiency virus).

Grade A denotes that "The USPSTF recommends the service. There is high certainty that the net benefit is substantial." A Grade D definition means that, "The USPSTF recommends against the service. There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits."

What is cervical cancer screening?
  • The goal of cervical cancer screening is to detect precancerous cervical cell changes at a point when treatment can prevent the development of cervical cancer. Cervical cancer discovered at an early stage is typically easier to treat. By the time symptoms occur, the cancer has often spread, making it more difficult to treat. 
  • The three main ways to screen for cervical cancer are:
    • The human papillomavirus (HPV) test, which checks for infection with high-risk HPV types.
    • The Pap test (Pap smear or cervical cytology), which checks for cervical cell changes that could turn into cancer. 
    • The HPV/Pap cotest, which checks for both cervical cell changes and high-risk HPV.
Where to go for cervical cancer screening
  • Doctors' offices (primary care or ob/gyn), clinics, and community health centers offer Pap and HPV tests.
  • If you are not under the care of a primary care physician, you can find a clinic near you by contacting your state or local health department, the National Breast and Cervical Cancer Early Detection Program, a Planned Parenthood clinic, or NCI’s Cancer Information Service.
  • Test results usually come back in 1-3 weeks. Follow-up visits or tests may be needed.
Cervical Cancer Symptoms

Early-stage cervical cancer may not have symptoms. When symptoms do occur, they may include:

  • Vaginal bleeding after sexual intercourse
  • Vaginal bleeding after menopause
  • Abnormal vaginal bleeding
  • Watery vaginal discharge with odor or blood
  • Pelvic pain / pain during sex
Advanced cervical cancer symptoms may include the above symptoms along with:
  • Difficult or painful bowel movements
  • Difficult or painful urination
  • Backache
  • Swelling of the legs
  • Abdominal pain
  • Fatigue

While these symptoms may be caused by many conditions, it is important to see a health professional if you experience any of the listed symptoms, as they may indicate cervical cancer.

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