The age at onset of screening, its frequency, the age at stopping screening, all come under review as the pathology of cervical cancer has become better understood.
The screening programs of 10 years ago are no longer evidence based and will undoubtedly change as more data abut HPV-vaccinated women become available.
In the United States, the guidelines have been radically revised in the past 2 years.
Age to start testing: Age 21 years
Frequency of testing: Every 3 years (previously annually)
Cotesting with HPV DNA: Cotesting is not uniformly recommended
Age to stop testing: 65 years, provided the women has had consistently negative screening
There are at present no separate recommendations for HPV-vaccinated women.
It is clear that routine screening of low-risk women is becoming less intensive as evidence accumulates on the natural history of HPV infections.