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Last Updated: 2/17/2015  

Cervical Cancer

  • Advise patients to avoid smoking to decrease the risk for cervical cancer.

  • Vaccinate young women and young men against HPV to reduce the risk for cervical cancer.

  • Screen women between the ages of 21 and 30 for cervical cancer every 3 years using cervical cytology.

  • Screen women ages 30 to 65 every 3 years using cervical cytology, or every 5 years using the combination of cervical cytology and HPV DNA co-testing.

  • Screen HPV-vaccinated women using the standard age-based recommendations

  • Do not screen for cervical cancer in women over age 65 who have had adequate prior screening unless there is a history of high-grade precancerous abnormality or cervical cancer within the last 20 years.

  • Do not screen for cervical cancer in women who have had a hysterectomy with removal of the cervix unless there is a history of high-grade precancerous abnormality or cervical cancer.

  • Recognize postcoital bleeding as the most common presenting symptom of cervical cancer.

  • Perform colposcopy in any patient with an abnormal Pap smear showing HSIL, microinvasive cancer, or invasive cancer.

  • Perform colposcopy in any patient with a grossly abnormal cervix, even if the Pap smear is normal.

  • Obtain examination under anesthesia, chest radiograph, and IVP for staging of all women with cervical cancer.

  • Consider MRI or CT of abdomen and pelvis for further investigation of local spread for women with invasive cervical cancer on biopsy.

  • Recommend surgery, radiation, and/or chemoradiation based on clinical stage.

  • For women with cervical cancer diagnosed in pregnancy, adjust management based on cancer stage and duration of pregnancy.

DOI: 10.7326/d643
The information included herein should never be used as a substitute for clinical judgment and does not represent an official position of ACP.
Author(s) and Disclosures:
James Fanning, DO has nothing to disclose. Nikki Neubauer, MD has nothing to disclose. Anna Strohl, MD, MD has nothing to disclose.

One or more of the present or past ACP Smart Medicine physician editors worked on this module and had nothing to disclose: Davoren Chick, MD, FACP; Deborah Korenstein, MD, FACP; Marjorie Lazoff, MD; Richard Lynn, MD, FACP.

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