The American College of Obstetricians and Gynecologists (ACOG) recently issued guidelines for cervical cancer screening, which were published in the January 2016 issue of Obstetrics & Gynecology. The current guidelines appear before the FDA adopted the already marketed initial HPV test for cervical cancer screening, and the ACOG says that single-use HPV testing can be considered an alternative to current cytologic cancer screening for women older than 25 years. Screening can be discontinued in women older than 65 years of age who have had a negative screening history. The ACOG also recommends in its guidelines cytology screening every 3 years for women aged 21-29 years; for women aged 30-65 years, combined cytology and HPV screening is recommended every 5 years, or they can continue to have separate cytology screening every 3 years. However, ACOG does not recommend that women be screened for cervical cancer every year. David Chelmow of the Division of Obstetrics and Gynecology at Virginia State University Medical Center notes that HPV screening alone is an optional screening for women over the age of 25 and “has not been included in any significant guidelines.” Also, Dr. Chelmow noted that the inclusion of HPV testing as a cervical cancer screening tool was based on interim guidelines issued by the American Society for Colposcopy and Cervical Pathology (ASCCP) and the American Society of Gynecologic Oncology (SGO) in 2015, “and in the most recent guidelines, we chose to include this decision (to include HPV testing as a cervical cancer screening tool), recognizing it as an FDA-adopted tool and that if people want to adopt this tool, they should use the interim guidance as a basis.” Guidelines for HIV-positive women The new guidelines state that HIV-positive women under the age of 30 who can show normal cytology for three consecutive years can next have cytology testing every three years; in the past, they had to be tested annually.ACOG does not currently recommend combined screening for HIV-positive women under the age of 30. HIV-positive women over the age of 30 can have both single cytology and combined screening, with those who have had normal cytology for three consecutive years being able to have annual testing next, and those who have had one combined screening with normal results being able to have annual testing. ACOG does not recommend screening for women under 21 years of age, regardless of the age of the woman’s first sexual encounter, unless she is confirmed to be an HIV carrier. Only 0.1 percent of cervical cancer cases occur before the age of 20 for normal girls, and there is still a gap in the effectiveness of current screening methods for women in this age group.