Table 2: Recommendations of Other Groups about Pap Smear for Cervical Cancer Screening

OrganizationTest ParametersScreening IntervalDefinition of High RiskInterval for High RiskAge to Stop Screening
American College of Obstetricians and Gynecologists, 1995Onset of sexual activity or age 18, whichever occurs firstAnnual; after 3 years of normal Paps interval may be lengthenedWomen with multiple sexual partners or whose male sexual partners have had multiple partners; sexual intercourse at an early age; women whose male sexual partners have had other sexual partners with cervical cancer; women with current or prior HPV or condylomata or both; women with current or prior herpes simplex virus infections; women infected with HIV; women with a history of STDs; women who are immunosuppressed; smokers and abusers of other substances, including alcohol; women who have a history of cervical dysplasia or cervical cancer or endometrial, vaginal, or vulvar cancer; women of lower socioeconomic statusAt physician discretionNo end date
American Society of Clinical Pathologists, 1999Age 18 or sexually activeOnce a yearCancer, precancerous lesions, a variety of infectious conditions3 - 6 months or colposcopyContinuing for the rest of her life
American College of Preventive Medicine, Practice Guidelines Committee, 1996At onset of sexual activity or age 18 if sexual history is unknownAt least 2 initial screening tests 1 year apart; then interval lengthened at discretion of patient and doctor, but not to exceed >3 year intervalNot mentionedNot mentionedAge 65, if no abnormal smears in the prior 9 years, unless patient has not been screened adequately
American Academy of Family Physicians, 1996Women who have ever had sex and have a cervixAt least every 3 yearsNot mentionedNot mentionedNot mentioned
Canadian Task Force on Preventive Health Care, 1992Women > age 18 who have had sexual intercourseTwo annual screens, then every 3 yearsEarly onset of sexual intercourse; many sexual partners; sexual partner with many sexual partnersMore frequently than 3 yearsUntil age 69
American Cancer Society, 2000Sexually active or Age18 (as prior entries)Annually until 3 or more consecutive satisfactory examinations, then at physician discretionNot mentionedNot mentionedGeneral cancer check-up recommendations suggest annual exam continue past menopause
Institute for Clinical Systems Improvement, 2000Sexually active women younger than age 18 and all women aged 18-64. Omit women who have had a hysterectomy with no residual cervix3 consecutive normal smears and no dysplasia within 5 years, then less frequently, but at least every 3 yearsMandelblatt Risk Factor Table of Relative RiskAnnually until no longer show dysplasia within 5 yearsAge 65
UK National Health Service Cancer Screening Progammes, 1999Age 20. Omit women who have had a total hysterectomy for nonmalignant reasonsAt least every 5 years (free cervical smear test)Certain types of HVP; women with many sexual partners or whose partner has had many partners; long-term use of the pill; women who smokeNot mentionedAge 64
Australian National Cervical Screening Program, 1998Women who have ever been sexually active beginning at age 18-20Every 2 yearsNot mentionedNot mentionedAge 70 with 2 normal Paps in prior 5 years
New Zealand National Cervical Screening ProgrammeWomen who have ever had intercourse beginning at age 20. Women who have had a total hysterectomy for a benign condition do not require further screeningEvery 3 years, except if > 5 years since last or if first smear, then repeat in 1 year's timeSexual behavior, smoking, hormonal or contraceptive use

Immunocompromised women
More frequent screening is not recommended for women possibly at higher risk of cervical cancer as there is no evidence that such women have a shorter duration of the preinvasive stage. Immunocompromised women should be screened annually.Age 70

From: 1, Introduction

Cover of Screening for Cervical Cancer
Screening for Cervical Cancer [Internet].
Systematic Evidence Reviews, No. 25.
Hartmann KE, Hall SA, Nanda K, et al.

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