The 2012 national recommendations for cervical cancer screening will produce a lower level of cervical cancer protection than previously afforded by annual cytology or 3-year cotesting. After a single negative cotest result, the risk of cervical cancer is twice as large at 5 years as it is at 3 years. Modeling published since the 2012 guidelines were drafted indicates that extending the cotesting screening interval from 3 to 5 years at ages 30–64 years will result in an additional 1 woman in 369 compliant with screening receiving a cervical cancer diagnosis during her lifetime, and an additional 1 in 1,639 dying of cervical cancer. The authors believe that a significant number of patients and providers would not choose to accept these additional risks if they understood them, despite the recognition of potential harms associated with more intensive screening.
The 2012 national recommendations for cervical cancer screening will produce a lower level of cervical cancer protection than previously afforded by annual cytology or 3-year cotesting.
Department of Women's Health, the Permanente Medical Group, Sacramento, California; the Department of Pathology (emeritus) and the Division of Gynecologic Oncology, Columbia University College of Physicians and Surgeons, New York, New York; the University of Connecticut, Farmington, Connecticut; the University of California (retired), Santa Barbara, California; and the University of Alabama, Birmingham, Birmingham, Alabama.
Corresponding author: Helen E. Dinkelspiel, MD, Columbia University College of Physicians and Surgeons, Division of Gynecologic Oncology, 161 Fort Washington Avenue, HIP 8-838, New York, NY 10032; e-mail: email@example.com.
Financial Disclosure Dr. Wright has worked on studies of HPV diagnostics for Roche, BD, Cepheid and Gen-Probe. Dr. Cox has served on the Scientific Advisory Boards of Hologic, Trovagene, and Zilico, the Data Steering Committee for Roche, the HPV Vaccines Data and Safety Monitoring Board for Merck, and on the Speakers Bureaus for Roche and Hologic. Dr. Huh serves on the Scientific Advisory Board for Merck. The other authors did not report any potential conflicts of interest.