What is the rationale behind the latest Guidelines?
- Primarily, the rare incidence of invasive cervical cancer in women younger than age 21, and the
potential harm due to the unnecessary treatment of precancerous lesions as a result of screening,
prompted this recommendation to start screening no earlier than age 21.
- There is really no significant difference in cervical cancer reduction between 2-year and 3-year screening
intervals - and the fact that HPV testing:
a. Improved the sensitivity of CIN 2+ detection
b. Provided such a wonderful negative predictive value - and longer protection.
- Screening discontinuation for women ages >65 is based on the rare incidence of cervical cancer and the low prevalence of CIN 2+ lesions in well-screened women older than age 65.
