How to screen for cervical cancer?

  Regarding TCT screening, it is becoming popular. A guideline for cervical cancer screening has just been introduced at the end of 2009. In China, we recommend that every married woman should have a routine annual physical examination and a cervical smear 1-2 years.  The latest guidelines for cervical cancer screening: Level 1: 1. Cervical cancer screening should begin in women over 21 years of age and should not start too early to avoid unnecessary panic among the low-risk group and unnecessary treatment.  2. Women in the age group of 21-29 years should be screened every two years.  3. Women over 30 years of age who do not have CIN2 or CIN3, are not HIV-infected, are not in an immunosuppressed state (e.g., immune disease or post-transplant patients requiring long-term immunosuppressive drugs), do not have a history of in utero DES exposure (which usually means that their mother has received inappropriate estrogen therapy during pregnancy), and have three consecutive screening results that are The screening interval can be changed to once every three years if the results are normal.  4. Screening methods available include TCT and traditional Pap smear.  5. If a woman has had her uterus removed for benign lesions (fibroids, or benign ovarian tumors) and has no previous history of high-grade cervical lesions, she may not be screened for cervical cancer.  6. For women over 30 years old, the best screening method is to have both cytological screening and cervical HPV testing, and if both results are normal and belong to the low-risk group of cervical cancer, the screening interval should preferably be more than three years.  Level 2: 1. Young women under 21 years old who have already started their sexual life and are sexually active should be counseled on sexually transmitted diseases, safety of sexual behavior, contraceptive methods, etc. There is no need for cervical cancer screening, and if there are no symptoms, there is no need to use speculum for vaginal examination.  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 insist on cervical cancer screening even if they have had their uterus removed.  Level 3: 1. Even though annual cervical cancer screening is not necessary, women should still undergo gynecological examination once a year.  2. Adolescents who have received HPV-16 and HPV-18 vaccines should follow the same screening guidelines as above as non-vaccinated individuals once they have started their sexual life.