The American Cancer Society (ACS) has updated
its guidelines for cervical cancer screening. The new guidelines are for
people with a cervix with an average risk of cervical cancer.
For
people aged 25 to 65 years, the preferred screening recommendation is to
get a primary human papillomavirus (HPV) test every 5 years. A
primary HPV test is an HPV test that is done by itself for screening. The US
Food and Drug Administration (FDA) has approved certain tests to be primary
tests.
Because
these HPV tests may not be widely available in the US yet, the guidelines
include these two other acceptable screening methods and
schedules.
Or
·
A
pap test alone every 3 years.
The most important thing to remember is to get screened
regularly, no matter which test you get.
The
2020 guidelines also recommend that people older than age 65 with a cervix stop
being screened as long as they’ve had 10 years of regular screening with normal
results. Otherwise, they should continue to be screened until they do.
Those
who have had their cervix removed, such as from a hysterectomy, don’t need
screening as long as the surgery was done for reasons not related to cervical
cancer or serious pre-cancer.
People
who have gotten the HPV vaccine should still follow the screening guidelines as
listed above.
The full, updated guideline was published online July
30, 2020 in CA: Cancer Journal for Clinicians. The journal also has
a patient page.
How
cervical cancer starts and how to find it early
The
cervix connects the uterus to the vagina. It’s part of the path babies pass
through during birth. Cancer that starts in the cells of the cervix is called
cervical cancer.
Almost all cervical cancers are caused by an HPV
infection. Most people will never
know they have HPV because the body can usually fight the infection before any
symptoms occur. But high-risk types of HPV (such as HPV 16 and HPV 18) can
cause serious pre-cancers and cancers of the cervix.
The goal of cervical cancer screening is to find pre-cancers
that are likely to progress to cancer and to remove or treat them before they
do. Screening can
also find cervical cancer at an early stage, when it is easier to treat.
Both
types of screening tests, the HPV and Pap tests, require a small sample of
cells from the cervix. A healthcare provider collects these by using a special,
small tool to gently scrape or brush the cervix. The same set of cells is used
for both tests.
·
The Pap test looks for
changes in the cells that might be pre-cancer or cancer.
·
The HPV test looks in
the cells for infection by high-risk types of HPV that are most likely to cause
pre-cancer or cancer.
Although
all the screening tests are good at finding cancer and pre-cancer, primary HPV
testing is better at finding them than a Pap test done alone. Plus, primary HPV
testing does not lead to more follow-up tests for abnormal areas that turn out
to not to be pre-cancer.
In
the US, the expectation is that over time fewer people will have a co-test or
Pap test alone as the primary HPV test become more widely available.
“When
we combine improved HPV vaccination rates with the screening and treatment of
pre-cancers in the cervix, we have the potential to make history by eliminating cervical cancer," said Debbie Saslow, PhD,
a co-author of the 2020 ACS updated guideline.
How do
you know if you’re at average risk for developing cervical cancer?
It’s
a good idea to talk with your healthcare provider about your risk for cervical
cancer and the screening guidelines that will protect you best. These updated
screening guidelines are only for people at average risk.
You
are at average risk if you don’t have any symptoms of cervical cancer and any
of these is true.
·
It’s the first time
you’re getting screened.
·
Your results have been
normal every time you’ve been screened before.
·
You had an abnormal
result checked and your healthcare provider told you that you could follow the
screening schedule for people at average risk.
You
need to talk to your healthcare provider and follow different guidelines if
either or both of these are true.
·
You’ve had pre-cancer
or cancer of the cervix in the past.
·
You have a weakened
immune system. This includes, for example, people who have human
immunodeficiency virus (HIV) or had an organ transplant or stem cell
transplant. It also includes people whose mothers took diethylstilbestrol (DES) when she was pregnant with
them.
If you
have an abnormal cervical screening test result
Discuss
your results carefully with your healthcare provider because there
are many different follow-up schedules, tests, and treatment options depending
on your specific risk of developing cervical cancer.
Don’t wait to see a doctor if you have problems between
screenings. See a doctor
right away if you have symptoms of cervical cancer—don’t wait to be screened.
These symptoms include unusual bleeding or discharge from the vagina or pain
during sex.
No comments:
Post a Comment