NEW YORK, Dec 11: The US Preventive Services Task Force (USPSTF) has released a draft recommendation suggesting that testing for high-risk human papillomaviruses (HPV) every five years – even with a self-collected sample – is the “preferred screening strategy” for cervical cancer beginning at age 30.

Historically, many women have been screened for cervical cancer through cervical cytology, commonly known as Pap tests or Pap smears, which involve collecting cells from the cervix to check for signs of cancer. However, the new draft recommendation, published on Tuesday, emphasizes HPV testing as the primary screening method for women aged 30 to 65, since most cervical cancers are caused by the virus. The HPV test requires a vaginal sample to check for infection with high-risk HPV types that can lead to cervical cancer.

Dr. Esa Davis, a task force member and professor at the University of Maryland, stated, “We are highlighting that HPV screening, as the primary screening for women ages 30 to 65, is the best balance between the benefits and the harms in detecting cervical cancer, and that should be offered first when available.”

For the first time, the draft recommendation also includes the option for women to self-collect their vaginal samples for HPV testing. Dr. Davis noted, “Now we have an additional screening test that may be more appealing to those who otherwise would not come in for screening, and that’s with self-collection.”

If HPV testing is unavailable, the recommendation suggests performing a Pap test or co-testing with both HPV testing and cervical cytology. While HPV testing is deemed the most effective, the other two methods remain viable options, Dr. Davis explained.

The update to the recommendation is not because Pap tests are harmful but because HPV tests are considered more effective in screening for cervical cancer in women aged 30 to 65. The draft also continues to recommend cervical cytology alone every three years for women in their 20s.

This draft recommendation is open for public comment until January 13, and a draft evidence review will also be available. The USPSTF is an independent panel of medical experts whose recommendations influence doctor’s decisions and insurance plans.

The American Cancer Society supports the use of HPV testing as part of cervical cancer screening and notes that HPV tests are better at preventing cervical cancers than Pap tests alone. Dr. Robert Smith of the American Cancer Society emphasized the importance of these screening guidelines, saying, “Cervical cancer is one of the most preventable and treatable types of cancer, and it is essential that women get screened regularly.”

Approximately 80% of people will contract an HPV infection during their lifetime. HPV is a group of more than 150 viruses, spread mainly through sexual contact. It includes low-risk strains that typically cause warts and high-risk strains associated with cancers such as cervical, anal, penile, and oropharyngeal cancers.

HPV infections usually clear on their own within two years, but if they persist, they can lead to health problems, including cancer. Early detection through HPV testing is crucial for monitoring and managing these infections.

When finalized, the new recommendation will update the USPSTF’s 2018 cervical cancer screening guidelines. At that time, the task force recommended three screening options for women aged 30 to 65: screening every three years with cervical cytology, every five years with HPV testing alone, or every five years with both HPV testing and cytology. For women under 21 and over 65, and those with adequate previous screenings and no other risk factors, the task force recommended against screening.

Dr. Davis stressed the importance of regular screening for cervical cancer in women aged 21 to 65, stating, “Cervical cancer is very preventable and treatable, and early detection is really important.” The introduction of self-collection HPV tests in this draft may help expand access to screening for women who otherwise might not come in for testing.

In May, the US Food and Drug Administration (FDA) approved two HPV tests for self-collection of vaginal samples. This option allows patients who cannot or prefer not to have a healthcare professional collect their sample to perform the test themselves in a healthcare setting, such as a doctor's office or mobile clinic. This option is similar to how patients may self-collect a urine sample during a doctor visit.

Dr. Davis noted that self-collection could increase access for women who might feel more comfortable with this option, ultimately helping to screen more women who might otherwise not have come in for testing. "We wouldn’t want any barriers for women who are eligible to be screened," she said, emphasizing that cervical cancer is preventable when detected early.