What is the process of cervical cancer screening?

  Cervical cancer screening should start at age 21; screening should be conducted every 2 years for those aged 21-30 years; screening can be conducted every 3 years for those aged ≥30 years if 3 consecutive screening results are negative; screening can be stopped for those aged 65-70 years if 3 consecutive screening results are negative and no abnormal results have been obtained in the last 10 years. Risk factors for those who need to be screened more frequently include HIV infection, immunocompromised or suppressed, history of uterine vinblastine exposure, and history of treatment for CIN 2 or 3 or cervical cancer.  Guidelines based on Level A evidence recommend that: 1. Screening for cervical cancer should begin in women over 21 years of age and should not be started too early to avoid unnecessary fear in low-risk groups, and unnecessary treatment.  2. Women in the age group of 21-29 years should be screened every two years.  3, For women ≥ 30 years of age, if they have 3 consecutive negative cervical cytology screening results, no previous history of CIN grade 2 or 3, no HIV infection, no immune deficiency, and no history of vinblastine treatment, the frequency of screening can be changed to once every 3 years.  4, Screening methods available, including TCT and traditional Pap smear.  5.If a woman has had her uterus removed for benign lesions and has no previous history of high-grade cervical lesions, screening for cervical cancer may no longer be performed.  6. For women over 30 years of age, the best screening modality is simultaneous cytologic screening (TCT) and cervical HPV testing. If both results are normal and they are in the low-risk group for cervical cancer, the screening interval should ideally be at least three years.  Guidelines based on level B evidence recommend that: 1. Young women under 21 years of age who have already started sexual intercourse and are sexually active should be counseled about sexually transmitted diseases and the safety of sexual behavior and contraceptive methods, and do not need to be screened for cervical cancer, nor is it necessary to use a speculum for vaginal examination if there are no symptoms.  2. For older women aged 65-70, cervical cancer screening can be stopped if the results of three consecutive screening tests are normal and there have been no abnormal test results in the past 10 years.  3. Patients with previous history of CIN2-3 or cervical cancer treatment should insist on annual cervical cancer screening for at least 20 years.  4. Patients with previous CIN2-3 should be screened consistently for cervical cancer, even if they have had their uterus removed.  Guidelines based on Level C evidence recommend that: 1. Even though annual cervical cancer screening is not necessary, women should still have annual gynecologic examinations.  2. Adolescents who have received the HPV-16 and HPV-18 vaccines should follow the same screening guidelines as unvaccinated individuals once they have started having sex.