Primary Screening for Cervical Cancer: Incorporating New Guidelines and Technologies into Clinical Practice

Cervical cancer screening has been a remarkable success story in the United States. The annual Papanicolaou (Pap) test is ingrained in the U.S. healthcare system, yet recent evidence suggests that many women do not need yearly screening. The American College of Obstetricians and Gynecologists' (ACOG) newest guidelines, published in December 2009, challenge traditional cervical cancer screening modes and intervals with level-A recommendations for starting later and screening low-risk women less frequently. The aim of this article is to provide an evidence-based approach to incorporation of the new cervical cancer screening guidelines into clinical practice by reviewing the goals of screening, epidemiology of human papillomavirus and cervical cancer, costs of overscreening, and rationale for the specific recommendations.