Screening for cervical cancer

医学 指南 子宫颈 宫颈癌 子宫切除术 产科 妇科 宫颈筛查 医疗保健 癌症 宫颈癌筛查 阴道分泌物 考试(生物学) 家庭医学 巴氏试验 卫生专业人员 癌症筛查 宫颈管 梅德林 子宫颈 阴道出血 子宫
出处
期刊:CA: A Cancer Journal for Clinicians [Wiley]
卷期号:76 (1): e70049-e70049
标识
DOI:10.3322/caac.70049
摘要

Screening for cervical cancerThe American Cancer Society (ACS) has updated its guideline recommendations for cervical cancer screening.The cervix is the bottom part of the uterus that connects it to the vagina.Regular screening for precancerous changes can greatly lower your chances of developing cervical cancer.This update reflects new research and advances in medical testing, and it builds on the previous ACS cervical cancer screening guideline from 2020. Do these recommendations apply to you?These recommendations apply to people at average risk for cervical cancer.This includes you if all of the following are true: You have a cervix.Everyone who has a uterus also has a cervix.If you had a hysterectomy (a surgery to remove the uterus), your cervix may have been removed.If your cervix was removed (as part of a total hysterectomy), you don't need screening anymore unless the surgery was done for cancer or a precancerous problem.If your cervix was not removed (sometimes called a partial hysterectomy), you still need screening.Ask your health care provider if you're not sure. You don't have symptoms that could be related to cervical cancer, such as vaginal bleeding when you do not have your period, vaginal discharge, or pain in your pelvis.If you have symptoms and you're not sure what they mean, talk with your health care provider as soon as possible. You've never had an abnormal cervical cancer screening (Pap or HPV) test or, if you did, your results have been normal for many years.If you have had abnormal screening test results in the past, your health care provider will help you determine the screening regimen that is best for you. These recommendations apply to you even if You've received the human papillomavirus (HPV) vaccine.Getting the HPV vaccine greatly reduces your risk of cervical cancer, but it doesn't eliminate it completely.HPV vaccines are much more effective when given during adolescence, so you will be most protected if you got your vaccine when you were a preteen or teenager. You're in a long-term relationship with the same partner, have stopped having children, do not have sex with men, or are not sexually active.Although HPV is most often transmitted through sex, HPV infections that cause cervical cancer can sometimes appear decades after you were first exposed. You're in menopause.Cervical cancer risk increases with age, so it's very important to keep screening through at least age 65 even if you don't have your period anymore. ACS screening recommendationsIf you meet these criteria, the ACS recommends that you start screening for cervical cancer at age 25 and continue until you are at least age 65. Primary HPV testingThe preferred screening is primary HPV testing (a test only for HPV infection) on a sample collected by a health care provider, which should be done every 5 years if your test is negative.For this test, the health care provider inserts a speculum in your vagina to collect cells from your cervix.These cells will be tested for HPV, the virus linked to nearly all cases of cervical cancer.This approach is preferred because, if anything abnormal is found, the lab can test the cells further. Other testing options Self-collected HPV testingA newer type of primary HPV testing allows you to collect your own vaginal sample by inserting a soft swab into your vagina.This selfcollection can be done privately, either in a clinic or doctor's office, or at home.If you choose self-collection for screening, a health care provider still needs to order the test, and it should be done every 3 years if your test is negative. Co-testingIn some locations, HPV testing is combined with a Pap test (a test that looks at the cervical cells under a microscope).This is called
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