TABLE 4.

Summary of current (2012) cervical cancer screening guidelines for average-risk women from the American Cancer Society (ACS), American Society for Colposcopy and Cervical Pathology (ASCCP), American Society for Clinical Pathology (ASCP), U.S. Preventive Services Task Force (USPSTF), and American College of Obstetricians and Gynecologists (ACOG) with interim guidance from the Society of Gynecologic Oncology and ACOG^a

Age (yr)	Screening recommendations
21	Initiation of screening
21–29	Cytology every 3 yr, or primary HPV testing can be considered starting at age 25 every 3 yrb; if primary HPV testing is positive, test for HPV16 and HPV18 and refer to colposcopy if positive or reflex to cotesting if negative
30–65	Cytology every 3 yr and HPV testing for triage of ASC-US, or HPV cotesting every 5 yrc and test for HPV16 and HPV18 if normal cytology but HPV positive, or primary HPV screening every 3 yrb as indicated above
Discontinuation of screening	Women age >65 who have 3 or more consecutive negative cytology tests or two consecutive negative cotests within 10 yr with the most recent test performed within 5 yr; women of any age who have a total hysterectomy and have no history of cervical cancer or precancer should not be screened

^aSummarized from references 102, 103, and 104. (Adapted from reference 105 with permission from Elsevier.)

^bInterim guidance (182).

^cHPV cotesting is the preferred screening method according to ACOG guidelines and is a grade A recommendation (as is cytology every 3 years) by USPSTF. ACS designates cotesting as a strong recommendation but as the preferred method a weak recommendation.