November 21, 2009

New Guidelines for Cervical Cytology Screening Released

The American College of Obstetricians and Gynecologists (ACOG) released its new clinical management guidelines for cervical cytology screening today.

New Recommendations
  • Screening should begin at age 21 years (previously at the age of first sexual intercourse)
  • Frequency of screening: every two years for women aged 21-29 years; for women aged 30 and older -- if results have been negative for intraepithelial lesions and malignancy for three times they may be screened at every three years
  • More frequent screening may be done in high-risk groups including: HIV infection, immunosuppression, exposure to diethylstilbestrol in utero, previously treated for CIN2, CIN3 or cancer
  • Discontinue screening: at either 65 or 70 years in women with three or more negative cytology test results in a row and no abnormal results in the past 10 years; immediately after total hysterectomy for benign indications and no prior history of high-grade CIN
  • Both liquid-based and conventional methods for cervical cytology are acceptable for screening
  • Co-testing with a combination of cytology and HPV DNA testing: appropriate for women older than 30 years.

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