Image: Adobe Stock<\/em>The organization advised that clinicians should only offer the option of self-collection \u201cif patients prefer this method and if appropriate clinical infrastructure and oversight for notification, documentation and referral for follow-up as indicated are in place.\u201d<\/p>\n
Primary hrHPV testing every 5 years is preferred for women aged 30 to 65 years, the recommendations published in Obste<\/i>t<\/i>ric<\/i>s<\/i> & Gynecology<\/i> said, while the guidance offers the option of co-testing with hrHPV and cervical cytology.<\/p>\n
Cervical cytology alone in this age group \u201cshould be used only in settings in which primary hrHPV testing or co-testing is not available or if, after counseling, the patient chooses cervical cytology alone,\u201d according to the recommendations.<\/p>\n
Women aged 21 to 29 years should receive screening with cervical cytology every 3 years, the guidance states, while women older than 65 years who are either at high risk or have not received adequate prior screening, \u201cdefined as three consecutive negative cytology results or two consecutive negative co-testing results within 10 years before stopping screening, with the most recent test occurring within 3 years for cytology alone or 5 years if co-testing is used,\u201d should continue to be screened.<\/p>\n
\u201cToo many people in the United States are needlessly suffering from cervical cancer. Underscreening \u2014 and lack of screening \u2014 is the most significant contributor to the development of this largely preventable illness,\u201d ACOG President Steven J. Fleischman, MD, MBA, FACOG,<\/b> said in the release. \u201cAll patients deserve access to screening options grounded in the best available science, and it is our goal to ensure that clinicians have the clear, evidence-based guidance they need to make that happen.\u201d<\/p>\n
According to guideline author Christopher Zahn, MD, FACOG,<\/b> ACOG\u2019s chief of clinical practice, women in underserved communities have higher cervical cancer incidence and mortality rates, \u201cand closing the gap requires screening to be appropriate, evidence-based and accessible. These updated recommendations, including patient-collected hrHPV testing, give clinicians new tools to reach patients who have historically faced barriers to screening \u2014 but this expanded access must be paired with appropriate counseling and the necessary infrastructure.\u201d<\/p>\n
Andrew<\/b> <\/b>M.D.<\/b> <\/b>Wolf, MD, FACP,<\/b> Professor Emeritus of Medicine at University of Virgina School of Medicine and chair of the American Cancer Society Screening Guidelines Development Group, told Healio that inclusion of the option for self-collected testing \u201cis a huge step forward to expand access to screening and save more lives. Most self-collection devices currently available are only approved for use in the clinical setting, meaning patients collect the sample while in the office. This is still a big step forward, since many primary care clinicians defer cervical cancer screening due to lack of time during the office visit \u2014 self testing can address this barrier.\u201d<\/p>\n
Wolf added that many women \u201cwill prefer self-testing over clinician exams for comfort reasons. Currently, only the Teal Wand [Teal Health] is approved for at-home collection, but there will be more options down the road. Clinicians and patients should also understand that if the self-collected HPV test is positive, the patient will need to return for a clinician-collected cytology (pap) test.\u201d<\/p>\n
Wolf underlined that cervical cancer \u201cis almost completely preventable by HPV vaccination. Clinicians should be vaccinating all children between the ages of 9 and 12, and definitely by age 26.\u201d<\/p>\n
*Editor\u2019s note: Wolf\u2019s interview reflects his own views and opinions, not his affiliations or institutions.<\/i> <\/p>\nFor more information:<\/h2>\n
Andrew<\/b> <\/b>M.D.<\/b> <\/b>Wolf, MD, FACP,<\/b> can be reached at primarycare@healio.com.<\/p>\n\n
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Sources\/Disclosures<\/h3>\n Source: <\/h2>\n \nPress Release\n<\/p>\n
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