Secondary Prevention of Cervical Cancer: ASCO Resource-Stratified Clinical Practice Guideline

<Primary Screening>

  • Human papillomavirus (HPV) DNA testing is recommended in all resource settings.
  • Visual inspection with acetic acid may be used in basic settings.
  • The recommended age ranges and frequencies in each setting are as follows:
  1. Maximal: 25-65 years, every 5 years
  2. Enhanced: 30-65 years, if two consecutive negative tests at 5-years intervals, then every 10 years
  3. Limited: 30-49 years, every 10 years
  4. Basic: 30-49 years, one to three times per lifetime


<Exiting Screening>

  • Maximal and enhanced: > 65 years with consistently negative results during past > 15 years
  • Limited and basic: < 49 years, resource-dependent; see specific recommendations


  • In basic settings, visual assessment for treatment may be used after positive HPV DNA testing results. ◦If visual inspection with acetic acid was used as primary screening with abnormal results, women should receive treatment.
  • For other settings, HPV genotyping and/or cytology may be used.


  • <After Triage>

  • Women with negative triage results should receive follow-up in 12 months. ·In basic settings, women should be treated if there are abnormal or positive triage results.
  • In limited settings, women with abnormal results from triage should receive colposcopy, if available, or visual assessment for treatment, if colposcopy is not available.
  • In maximal and enhanced settings, women with abnormal or positive results from triage should receive colposcopy.



2016 ASCO guideline