Cervical cancer is the fourth most common cancer in women worldwide. In the US, deaths from cervical cancer have decreased by more than 50 percent over the past 60 years, since the introduction of regular screening tests that detect high-grade precancerous cervical lesions and cervical cancer. However, over 13,000 women are diagnosed with cervical cancer annually and about 4,200 women die from it, even with screening and treatment. Recommendations continue to evolve, reflecting the latest screening technology and evidence. The new USPSTF recommendations for screening have been recently published in the latest issue of JAMA. Women over 30 now have three options for screening, including HPV testing alone; the other two options are pap smear and a combination of pap smear and HPV testing. HPV testing has been shown to be more effective than a pap test as it is able to detect precancerous cells earlier and more accurately than cytology. These screening guidelines update the previous guidelines; now, for women over 30, HPV testing alone can be done every 5 years, rather than co-testing with a pap smear. For women under 30, and women receiving pap testing alone, without HPV testing, the screening interval is still 3 years.
Cervical cancer disproportionately affects women of color. Cervical cancer deaths among African American women (0.1 deaths per 100 000 women) occurs more than than twice the rate among white women, although this gap has narrowed. Other racial/ethnic groups such as American Indian/Alaska Native women and Hispanic women also have higher rates of cervical cancer mortality than the US average at 3.2 deaths per 100 000 women and 2.6 deaths per 100 000 women, respectively.
The key to decreasing the number of deaths associated with cervical cancer are prevention and early detection. Further research on the cost-effectiveness of HPV testing as primary screening as well as strategies to improve patient education while taking all women of races and ethnicities into consideration are needed.