ACOG: Cervical Cytology Not Recommended for Adolescents

ACOG recommends cytology screening start at age 21 regardless of the onset of sexual activity
By Monica Smith
HealthDay Reporter

THURSDAY, July 22 (HealthDay News) -- Although prior recommendations of major societies advised cervical cytology screening in adolescents based on onset of vaginal intercourse, the American College of Obstetricians and Gynecologists now recommends that screening begin at age 21, regardless of sexual activity, due to the rarity of cervical cancer in women under 21. These recommendations have been published in the August issue of Obstetrics & Gynecology.

The Committee on Adolescent Health Care writes that cervical cancer is extremely rare in women less than 21 years of age and that screening women before they turn 21 does not change the rate of cervical cancer.

The committee suggests that cervical cancer screening begin at age 21, regardless of the age of onset of sexual activity, but emphasizes the importance of recognizing, if cytology is performed in women under 21, that management of adult and adolescent cervical cytologic abnormalities is different. They note that the American Society of Colposcopy and Cervical Pathology's 2006 consensus guidelines, which emphasize minimal or no intervention for cervical disease in adolescents, has resulted in major changes to cervical disease management in this population, and that the preferred management for cervical intraepithelial neoplasia in adolescents is observation.

"The guidelines were established to minimize the potential negative effect that screening can cause, unnecessary referrals for colposcopy, and the negative effect that treatment can have on future pregnancy outcomes," the authors write.

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