Proposed Changes to Cervical Cancer Screening Guidelines
The ACS, the ASCCP, the American Society for Clinical Pathology (ASCP), and the USPSTF have recently proposed new recommendations for prevention and detection of cervical cancer. Importantly, the proposed revisions advise reductions in screening frequency, to maximize benefits while minimizing risks.10 These recommendations are based on evidence suggesting that annual screening does not detect cancer more effectively than screening every three years, but does place women at higher risk for vaginal bleeding, pain, infection, and missed disease. Moreover, abnormal results may cause undue anxiety and lead to unnecessary therapy (e.g., treatment of lesions that would have otherwise regressed with time).2
Both the USPSTF and ACS-ASCCP-ASCP have drafted proposed guideline revisions, outlined in Table 3.10,13 Public feedback will be considered when developing final guidelines, which are to be released in mid-2012.2
Table 3. Proposed Changes to Cervical Cancer Screening Guidelines: Draft Recommendations10,13
Emerging Screening Technology: Spectroscopy
In addition to conventional screening techniques, spectroscopy may be used to identify cervical abnormalities by reflecting light changes in cervical tissue. Compared to the Pap test, spectroscopic devices offer various advantages. Namely, data are collected and analyzed in an objective fashion, thereby eliminating the potential for human error. In addition, the availability of immediate findings may enable more timely detection and management and eliminate the need to await biopsy results. Instruments may be used as an adjunct to cervical cytology, for triage after indeterminate cytology results, for localization of biopsy sites during colposcopy, or as primary screening alternatives.3
LightTouch and LuViva, two devices currently under investigation, have been shown to detect cervical disease up to two years in advance of traditional screening methods (e.g., Pap testing, HPV testing, colposcopy, biopsy).14,15 Findings revealed that LightTouch was able to detect over 86% of cervical abnormalities missed by conventional screening tests, and reduced the number of unnecessary biopsies by approximately 40%.15 Similarly, LuViva, which is under investigation for intermediary testing in women with abnormal Pap test results, was found to increase detection of CIN II/III by 20%.14 If approved for use, such devices may prove to be valuable tools for the detection and management of cervical cancer.