The latest guideline opinion on cervical cancer screening

  Malignant tumors in the cervical area are called cervical cancer. The cervical area is located at the tip of the vagina, and this physiological anatomy is unlike the uterus which is deep in the pelvis, or the heart, lungs and liver which need ultrasound and CT to be seen, it is very easy to be exposed and seen directly by a simple vaginal speculum examination by a doctor, so regular cytological screening tests of cervical exfoliated cells can detect very early precancerous lesions and The pre-cancerous lesions can be completely cured by the available medical technology, thus preventing the occurrence of cervical cancer.  In recent years, with the continuous progress in the field of medicine in China, the increasing awareness of health care among the general public, and the loud voice of medical workers, many adult women are aware of the need for regular gynecological examinations and the need for cervical cytology screening during gynecological examinations. As an obstetrician and gynecologist, this is a very gratifying social phenomenon.  There are also often inappropriate clinical perceptions, such as too frequent cancer screening, I have seen healthy women who have to be screened more than twice a year, or frequent rechecks by different medical units in a short period of time, or the idea that one cancer screening will protect them for life.  The American College of Obstetricians and Gynecologists (ACOG) published on November 20, 2009, the latest guidelines for cervical cancer screening are available: Leveal A 1. Cervical cancer screening should begin in women over 21 years of age, or under 21 years of age if they have been sexually active for more than 3 years; 2. Women in the 21-29 age group should be screened every two years.  3. Women over 30 years of age who do not have CIN 2 or CIN 3, are not HIV-infected, are not in an immunosuppressed state, do not have a history of treatment for DES exposure in utero, and have three consecutive screening results that are normal, can change the interval of screening to every three 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, she can be screened without cervical cancer.  6. For women over 30 years old, the best screening method is to perform both cytological screening TCT and HPV virus test, if both results are normal, they belong to the low-risk group of cervical cancer, and the interval of screening is better than three years.  Level B 1. Young women under 21 years old who have already started sexual life and are sexually active should be counseled on sexually transmitted diseases, safety of sexual behavior, contraceptive methods, etc. Cervical cancer screening is not necessary, and if there is no symptom there is no need to use a speculum for vaginal examination 2. Older women aged 65-70 years old, if the results of three consecutive screening tests are normal and there are no abnormal test results in the past 10 years Screening for cervical cancer can be stopped if there are no abnormal test results in the past 10 years.  3. Patients who have had CIN 2-3 should insist on cervical cytology screening even if they have had their uterus removed.  LevelC 1. Even if women belong to the group of people who do not need to be screened for cervical cancer every year, they should still undergo gynecological examination once a year.  2. Adolescents who have received HPV-16 and HPV-18 vaccines and have started their sexual life should follow the above screening guidelines as those who have not been vaccinated.