Routine cervical cytology cancer screening should be delayed until age 21, according to guidelines released Nov. 20 by the American College of Obstetricians and Gynecologists. ACOG previously recommended that screening begin three years after first sexual intercourse or by age 21. The updated guidelines also call for women 21-30 to be screened less often - every two years instead of annually, using either the standard Pap test or liquid-based cytology. In a Practice Bulletin to be published in the December issue of Obstetrics & Gynecology, AGOG explains that "the recommendation to start screening at 21 years regardless of the age of onset of sexual intercourse is based in part on the very low incidence of cancer in younger women," as well as the potential for adverse effects associated with follow-up of young women with abnormal cytology screening results. Screening can jump to every three years in women 30 and older who have had three consecutive cervical cytology test results that are negative for intraepithelial lesions and malignancy, ACOG notes. Women with defined risk factors may benefit from more frequent screening, the guidelines state
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