Cervical cancer screening should be done in a certain population, in a certain method and at a certain frequency. We have already talked about the screening method, but let’s talk about the screening population. The screening population we are talking about is usually married or sexually active women.
In addition, we have some high-risk groups to focus on.
1, those who have multiple sexual partners or are sexually promiscuous
2. women with a low age of first sexual intercourse
3, women whose male sexual partners have other cervical cancer sexual partners
4.Women with current or previous herpes simplex virus infection
5.Females with HIV infection.
6. women with sexually transmitted diseases, such as syphilis and gonorrhea
7, women who are receiving immunosuppressive therapy
8, women who smoke.
9, women with cervical lesions that have not been treated in a timely manner
10, women who have been or are infected with high-risk human papillomavirus.
The WHO recommends annual screening for women aged 21 to 64 years. Let’s look at the screening guidelines recommended by the American College of Obstetricians and Gynecologists (ACOG).
① Women under 21 years of age have relatively strong immune resistance and can clear up HPV infection on their own even if it occurs, mostly as a transient infection, so screening is not recommended for women in this age group.
② For women aged 21 to 29, screening cytology (Pap smear or TCT test) is recommended every 3 years.
③ For women aged 30 to 65 years, screening HPV testing with cervical cytology every 5 years, or cytology every 3 years.
④ Women older than 65 years of age who have had multiple previous tests that were negative do not need further screening. However, patients who have had CIN grade II, CIN grade III, or carcinoma in situ should continue to be screened for at least 20 years after treatment
⑤ Women who have had a hysterectomy do not need to be screened because they do not have a cervix. with one caveat: the patient has not had CIN grade II, CIN grade III, carcinoma in situ or cervical cancer in the past 20 years.
(6) Women who have received the HPV vaccine should not be taken lightly and need to follow the same screening recommendations as non-vaccinated women, following the age group.
The significance of combined screening with cervical cytology (TCT test or Pap smear) and HPV testing.
① HPV negative, cytology negative: very low risk of cervical cancer (convinced that 99% are not cancerous); re-screening after 3 years. Still recommended, annual pelvic and breast exams.
(ii) HPV positive, cytology negative: low risk of cervical cancer; repeat both tests after 6-12 months.
③HPV negative, indeterminate cytology: low risk of cervical cancer; repeat both tests after 12 months.
④HPV-positive, indeterminate cytology: medium risk of cervical cancer; further testing is recommended.
⑤ HPV negative, positive cytology: moderate risk of cervical cancer; further testing is recommended.
⑥HPV positive, positive cytology: high risk of cervical cancer; further examination is recommended.
According to domestic and international research and evidence-based medicine, as well as the specific situation of our country, we recommend that: married or sexually active women should be screened once a year, and the frequency of screening can be increased for high-risk groups as appropriate.
Finally, we remind you again that cervical cancer is a common gynecological malignancy, which seriously threatens women’s health and life. Cervical cancer screening can detect precancerous lesions and early cervical cancer at an early stage, and early detection, early diagnosis and early treatment can eliminate cervical cancer in the bud!