Cervical cancer screening (cytology, HPV test) and management after an abnormal result

Cervical sample (liquid-based)

• Liquid-based cervical cytology (smear)
• At age 25, then 1 year later, then every 3 years if the first two are normal.

Cervical sample (liquid-based)

• High-risk HPV test (the laboratory does reflex cytology if positive)
• First HPV test 3 years after the last normal cytology (or straight away if there has been none), then every 5 years if negative.

At 1 year (HPV positive, reflex cytology normal)

• Follow-up HPV testif neededPositive HPV test with normal reflex cytology: repeat HPV test one year later; if positive, colposcopy; if negative, return to the 5-year interval ^[1,4].

• No specific prescription: apply the tab for the age, unless stated below.
• High-risk HPV test (after age 65, if previous screening is absent or inadequate)if needednon-French guidelineThe USPSTF considers screening indicated after 65 years when previous screening was inadequate: most women with cervical cancer at that age had not been properly screened ^[8,9]. The American Cancer Society asks for two negative HPV tests at 60 and 65 years before stopping ^[7]. The French target stops at 65 years, with no condition on previous screening, with coverage of about 60% ^[1].