New guidelines for cervical cancer screening have been released by the American Cancer Society in conjunction with the U.S. Preventive Task Force (USPTF) that are based on new understanding of the role that human papillomavirus (HPV) infection plays in the development of this disease. The guidelines recommend less frequent testing across all age groups and are aimed at detecting early cellular abnormalities while at the same time reducing unnecessary biopsy procedures and the anxiety caused by false positive PAP smears. Vaccination against HPV has reduced the incidence of cervical malignancy but the vaccine only protects against for 70% of cervical malignancies. The decreased recommendations for screening may cause women to reduce the frequency of their gynecologic visits and consequently cause missed opportunities for the detection of other women’s health issues that are detected during routine visits.
Under both the new 2012 USPTA and 2012 ACS guidelines, women under 21 years of age are still not recommended for screening. Women age 21 – 29 should have PAP smears every 3 years and HPV testing is not recommended. Women age 30-65 should have PAP smears with HPV testing every 5 years and, if HPV testing is not done, screening should be every 3 years. Once women are 65 years or older, screening should be discontinued if screening has been done properly in the past. HPV testing alone is not recommended for screening purposes.
Cervical cancer is curable when detected at an early stage. Cytologic screening can be done by traditional PAP smear analysis, as well as by more efficient and sensitive methods known as ThinPrep® and SurePath® that allow for better visualization of the cells. However if there are errors in the interpretation of the slides, the failure to diagnose can result in the advanced spread of the disease, debilitating treatment and ultimately wrongful death. Britcher Leone & Roth uses expert cytopathologists to determine whether advanced cervical cancer was a result of errors in the screening process and, if so, to help women and their families whose lives have shattered by delayed diagnosis.