Help prevent cervical cancer with the right screening at the right time
Once the leading cause of cancer death for women in the U.S., cervical cancer is now the easiest gynecologic cancer to prevent—due to regular screening.1 In the last 40 years, routine Pap smears have helped to significantly reduce the number of cervical cancer cases and deaths in the U.S.2
Yet cervical cancer is still a persistent concern. An estimated 12,990 women will be diagnosed with cervical cancer in 2016, with approximately 4,120 deaths anticipated.1
As a primary care physician, you play a key role in ensuring that women, starting at age 21, get properly screened for cervical cancer and continue to do so in accordance with leading health organization guidelines for as long as necessary. Yet, for years, guidelines on the best screening approach varied.
Screening guidelines: Consensus
In 2012, consensus regarding cervical cancer screening recommendations by age was reached for the first time among leading health organizations, including USPSTF, ACS, ASCCP, ASCP, and ACOG.*3–5
These guidelines are still in place today.
- Start screening at age 21
- Ages 21–29: Pap test with reflex to human papillomavirus (HPV) if the Pap is ASC-US**; Pap test alone every 3 years is acceptable
- Ages 30–65: HPV and Pap test co-testing every 5 years is preferred; Pap test alone every 3 years is acceptable
- Stop screening women older than age 65 with evidence of adequate negative prior screening results and no history of CIN2 (moderate changes to the cells) or higher
- Some women are at higher risk than average for cervical cancer and require special screening protocols, including women who are HIV positive, immunosuppressed, or who have a history of CIN2, CIN3, or cervical cancer
Four essentials to improve cancer screening in your practice
About half of all cervical cancers occur in women who have never been screened, while another 10% occur in women who have not been screened in the last 5 years.3 You can make a difference by following consensus guidelines to appropriately screen female patients in your practice.
The American Cancer Society offers “four essentials” to help:6
- Make a recommendation—the primary reason patients say they are not screened is because a doctor did not recommend it; a recommendation from you is vital
- Develop a screening policy—create a standardized plan of action; engage your team in creating, supporting, and following the policy
- Measure practice progress—establish a baseline screening rate, and set a practice goal
- Be persistent with reminders—track test results, and follow up with patients
Also noteworthy: Cervical cancer screening is covered by health plans under the Affordable Care Act.
Ensuring that your female patients receive the appropriate testing for cervical cancer is a critical component of their overall care. At Quest Diagnostics, we are committed to offering accurate, guidelines-based screening options for cervical cancer, including Smart Codes, or age-based test codes, that can help streamline office ordering, and reports that integrate Pap and HPV results to help categorize patient risk for cancer. This combination of information helps provide important protection for your patients.
* USPSTF=United States Preventive Services Task Force; ACS=American Cancer Society; ASCCP=American Society for Colposcopy and Cervical Pathology; ASCP=American Society for Clinical Pathology; ACOG=American College of Obstetricians and Gynecologists.
** ASC-US = Atypical squamous cells of undetermined significance.
1. American Cancer Society. Cervical cancer. www.cancer.org/cancer/cervicalcancer/detailedguide/cervical-cancer-key-statistics. Accessed December 6, 2016.
2. Centers for Disease Control and Prevention. Cervical cancer statistics. www.cdc.gov/cancer/cervical/statistics/index.htm. Accessed November 27, 2016.
3. Saslow D, Solomon D, Lawson HW, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin. 2012; 62(3): 147-172.
4. US Preventive Services Task Force. Final Update Summary: Cervical Cancer Screening. www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/cervical-cancer-screening. Accessed November 27, 2016.
5. The American College of Obstetricians and Gynecologists. Practice Bulletin 168: Clinical management guidelines for obstetricians-gynecologists: cervical cancer screening and prevention. Obstet Gynecol. 2016;128: e111-130.
6. American Cancer Society, National Colorectal Cancer Roundtable, Thomas Jefferson University. How to increase preventive screening rates in practice. www.cancer.org/acs/groups/content/@editorial/documents/document/acspc-029276.pdf. Accessed November 27, 2016.