Primary-care providers continue to recommend annual cervical cancer screening, despite recommendations that suggest three-year intervals for such testing.
American Cancer Society and American College of Obstetricians and Gynecologists guidelines recommend that women aged 30 years and older undergo an HPV co-test — a Pap test and a human papillomavirus (HPV) test—and, if results are normal, waiting three years before being tested again.
However, when Katherine B. Roland, MPH, and colleagues surveyed 376 private office-based providers and 216 from hospitals and outpatient facilities, they found that less than 15% made the three-year recommendation and recommended annual screening instead. Results were published in the American Journal of Obstetrics & Gynecology.
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In related news, results of the large ATHENA study suggest that the HPV test should become the primary screening tool to rule out cervical cancer. Combining HPV testing and cytology provided little benefit over HPV testing alone (Lancet Oncol. 2011;12:880-890). Among subjects who underwent colposcopy, many more existing high-grade precancers were detected in those undergoing HPV testing than in those undergoing cytology.
A different project showed that contrary to popular belief, intrauterine devices (IUDs) might protect against cervical cancer. Although IUDs were not shown to affect the risk of HPV infection, Xavier Castellsagué, MD, and colleagues found that women with a history of IUD use had almost half the risk of developing cervical cancer than did those who had never used this method of birth control. The reduced risk was seen in the first year of use, with the protective effect remaining significant even after 10 years of use (The Lancet Oncology; published online ahead of print).
