The evolution of cervical screening and the specialty of obstetrics and gynecology

The American Cancer Society, the American Society for Colposcopy and Cervical Pathology, and the American Society of Clinical Pathologists have released revised consensus recommendations for cervical cancer screening. These new recommendations integrate molecular testing and include significant changes in screening, particularly in women from 30 to 65 years of age without complications who now may be screened every 5 years by co-testing with cervical cytology and high-risk human papillomavirus testing and women 21-29 years who may be screened with cervical cytology alone every 3 years. The revised recommendations include clarification on when to start and stop screening and management of women who have undergone hysterectomy. They also clarify the management of results of co-testing. The new recommendations achieve the same degree of protection against cervical cancer as previous recommendations. They require less screening and will be much more convenient for our patients. They are a further step away from the days of annual Pap tests, and the decreased requirements for cervical cancer screening pose an exciting opportunity for focusing on many other important health issues during the well woman visit.