HPV Testing Can Replace Pap Smears for Many Women, New Guidelines Say

Pap smears, long the gold standard for cervical cancer screening, may be used less frequently under new guidelines from the U.S. Preventive Services Task Force.

The recommendations, which were published Tuesday in JAMA, say that women between ages 30 and 65 can rely on human papillomavirus (HPV) testing instead of, or in addition to, Pap smears. Women in this age group should get HPV testing every five years, a Pap smear every three years or a combination of the two tests every five years, the guidelines say.

HPV causes the vast majority of cervical cancer cases, according to the National Cancer Institute, which makes HPV testing an effective preventative measure. A large 2014 study found that HPV testing, which screens for common strains of the virus, may be better at detecting cervical cancer risk than Pap smears, which involve taking a sample of cells from the cervix so that doctors can look for abnormal cells that could turn cancerous.

Women and their doctors should decide together whether they’ll rely on HPV testing, Pap smears or a combination of the two, the guidelines say.

Women ages 21 to 29, meanwhile, should continue to get Pap smears every three years, as the prior USPSTF guidelines recommended. Screening more frequently than that is not likely to confer any additional benefit for women in this age group, the guidelines say.

The USPSTF does not recommend cervical cancer screening for women younger than 21 or those older than 65 who have been adequately screened in the past and are not at an above-average risk of cervical cancer. In both of these age groups, the risk of harm from screening — including false positives and unnecessary procedures — likely outweighs the benefits, the USPSTF writes.

The new guidelines are the first from the USPSTF to recommend HPV testing alone. Its last set of guidelines, released in 2012, recommended it for women ages 30 to 65 in conjunction with Pap smears.

The Centers for Disease Control and Prevention (CDC) also recommends that all children get vaccinated against HPV at age 11 or 12, though the shot is effective when it’s administered up to age 26. Nonetheless, as of 2016, vaccination rates still lagged somewhere around 65% for girls and 56% for boys, research shows.