Comparison of recommendations for screening for cervical cancer
| Organization or country | Recommendation by age, yr | HPV testing | ||||
|---|---|---|---|---|---|---|
| < 20 | 20–24 | 25–29 | 30–69 | ≥ 70 | ||
| Canadian Task Force on Preventive Health Care (current)* | Recommend against routine screening | Recommend against routine screening | Every 3 yr with cervical cytology | Every 3 yr with cervical cytology | Every 3 yr with cervical cytology if previous screening inadequate and until 3 negative results have been received; otherwise, screening may stop | No recommendation; will revisit the issue as new data become available |
| Canadian Task Force on Preventive Health Care (1994)15 | Every year with cervical cytology after start of sexual activity or at age 18 yr | After 2 normal Pap results, every 3 yr to age 69 yr; frequency may be increased in the presence of risk factors | After 2 normal Pap results, every 3 yr to age 69 yr; frequency may be increased in the presence of risk factors | After 2 normal Pap results, every 3 yr to age 69 yr; frequency may be increased in the presence of risk factors | Not recommended | Not applicable |
| US Preventive Services Task Force (2012)42 | Recommend against routine screening under age 21 yr | Recommend against routine screening under age 21 yr Every 3 yr with Pap testing ages 21–65 yr | Every 3 yr with Pap testing ages 21–65 yr | Every 3 yr with Pap testing ages 21–65 yr Recommend against screening for women older than age 65 yr who have had adequate prior screening and are not otherwise at high risk | Recommend against screening for women older than age 65 yr who have had adequate prior screening and are not otherwise at high risk | In combination with cytology (cotesting), every 5 yr for women ages 30–65 yr who want to lengthen the screening interval |
| Government of Australia (2011)43 | First Pap test at about 18–20 yr or 1 or 2 yr after first having sex, whichever is later | Every 2 yr with Pap testing | Every 2 yr with Pap testing | Every 2 yr with Pap testing | Practitioner may advise that it is safe to stop Pap testing if previous results have been normal | No recommendation |
| National Health Service Cervical Screening Program, UK (2011)41 | Not invited to screen | Not invited to screen | Every 3 yr with cytology for women aged 25–49 yr | Every 3 yr with cytology for women aged 25–49 yr Every 5 yr with cytology for women aged 50–64 yr Women aged ≥ 65 yr to undergo screening only if they have not had screening since age 50 yr, or they have had recent abnormal test results | Women aged ≥ 65 yr to undergo screening only if they have not had screening since age 50 yr, or they have had recent abnormal test results | Additional (triage) HPV testing is recommended for women ≥ 25 yr with abnormal test results in some circumstances |
| Health Council of the Netherlands (2011)88 | Not invited to screen | Not invited to screen | Not invited to screen | Every 5 yr for women aged 30–40 yr Every 10 yr for women aged 50–60 yr | Not invited to screen | HPV should replace cytology as the primary screening method; if using Pap test, triage HPV testing is recommended for women ≥ 30 yr with abnormal test results in some circumstances |
| National Cancer Screening Service, Ireland (2011)89 | Not invited to screen | Not invited to screen | Every 3 yr for women aged 25–44 yr Every 5 yr for women aged 45–60 yr (regardless of age at first screening, women must have 2 normal results 3 yr apart before moving to a 5-yr interval) | Every 3 yr for women aged 25–44 yr Every 5 yr for women aged 45–60 yr (regardless of age at first screeing, women must have 2 normal results 3 yr apart before moving to a 5- yr interval) | Not invited to screen | No recommendation |
| National Health Service, Scotland (2010)90 | Not invited to screen | Every 3 yr for women aged 20–60 yr | Every 3 yr for women aged 20–60 yr | Every 3 yr for women aged 20–60 yr | Not invited to screen | No recommendation |
Note: HPV = human papilloma virus, Pap = Papanicolaou.
↵* Recommendations made for women who were ever sexually active. Recommendations do not apply to women with symptoms of cervical cancer or previous abnormal screening results, to women who do not have a cervix or to women who are immunocompromised.