The Canadian Task Force on Preventive Health Care releases updated Guideline for cervical cancer screening
Task Force says annual screening for asymptomatic women is unnecessary
OTTAWA, Jan. 7, 2013 /CNW/ – The Canadian Task Force on Preventive
Health Care (Task Force) today released an updated guideline on
cervical cancer screening, recommending women aged 25-69 be screened at
an interval of three years. The Task Force, an independent body of
fourteen specialists with expertise in prevention, and primary care in
Canada, says early and frequent (often annual) cervical screening is
unnecessary. The Guideline is published in the Canadian Medical
Association Journal – http://www.cmaj.ca/lookup/doi/10.1503/cmaj.121505.
The guideline is an update to that last published by the Task Force in
1994 and is based on the best and latest evidence in cervical cancer
screening. Aimed at physicians, policy makers and Canadian women, the
updated Guideline identifies the optimal use and frequency of screening
(Pap tests) for cervical cancer in asymptomatic women who are or who
have been sexually active, regardless of sexual orientation.
“Since the introduction of Pap tests in Canada, the proportion of women
getting cervical cancer has declined from 1.5% of all women to 0.66%,
and the proportion dying from cervical cancer had declined from 0.94%
to 0.22%” said Dr. James Dickinson, member of the Task Force and chair
of the guideline working group. “And while it is likely that most of
this improvement is a result of screening, other countries have
achieved similar outcomes despite initiating screening at an older age
and implementing longer screening intervals. Reducing the number of pap
tests gives women the benefit from screening, while reducing the
inconvenience, discomfort and potential harms caused by early and
The current guideline differs from the previous 1994 CTFPHC
recommendations in a number of ways:
1. The updated Guideline says routine screening is not recommended in sexually active women who are younger than 25. The 1994 Guideline recommended annual screening with Pap tests after initiation of sexual activity or at age 18. 2. The updated Guideline recommends asymptomatic women aged 25-69 (who are or have been sexually active) be screened at an interval of 3 years. The 1994 Guideline recommended women aged 20-69 be screened every three years - but only after 2 normal Pap tests. 3. In the updated Guideline, screening is now explicitly recommended in women older than 69, if prior screening has not been adequately performed. In the previous Guideline, screening women aged 70+ was not recommended.
“The greatest reduction in cervical cancer will be achieved by screening
more eligible women who have not previously been screened, and not by
screening more women earlier or more often,” according to the authors
of the Guideline. “Identifying the optimal use and frequency of
screening will help reduce the inconvenience, discomfort and potential
harms caused by early and excessive testing, while still ensuring the
greatest benefit from screening.”
The main recommendations of the Guideline include:
-- The Task Force recommends against cervical cancer screening (with Pap tests) for women aged younger than 25 because minimal or no benefit was found to outweigh the potential harms in this group. -- The Task Force found moderate quality evidence showing that screening with Pap tests may have a small effect in reducing cervical cancer mortality and morbidity among women aged 25-29 and recommends screening these women at intervals of 3 years. -- The Task Force found high quality evidence showing that screening for cervical cancer with Pap tests reduces mortality and morbidity among women aged 30-69, and strongly recommends screening these women at intervals of 3 years. -- Screening may cease in women aged 70 and older, but only after 3 successive negative Pap tests.
For the complete report and details of the recommendations, please visit
About the Canadian Task Force on Preventive Health Care
The Canadian Task Force on Preventive Health Care has been established to develop clinical practice guidelines that
support primary care providers in delivering preventive health care.
The mandate of the Task Force is to develop and disseminate clinical
practice guidelines for primary and preventive care, based on
systematic analysis of scientific evidence.
SOURCE The Canadian Task Force on Preventive Health Care