The National Comprehensive Cancer Network (NCCN) has updated the NCCN Clinical Practice Guidelines in Oncology for Cervical Cancer Screening to include new recommendations for women who have positive human papillomavirus (HPV) High Risk (HR) DNA test results but negative cervical cytology screen/Pap smears. These recommendations follow the approval of two new diagnostic HPV DNA tests: an updated HPV HR DNA test which determines whether any of the 14 oncogenic HPV types are present, but does not indicate which types are present, and the HPV 16/18 DNA test which determines whether HPV-16, HPV-18, or both are present.

The new section recommends that women ≥30 years of age who receive a positive result using the HPV HR DNA test but have a negative cervical cytology/Pap smear be tested with the more specific HPV 16/18 DNA test, or proceed directly to colposcopy. The NCCN guidelines recommend that HPV DNA testing complement cervical cancer screening methods (eg, as regular Pap smears and gynecologic examinations), not replace these methods.

The current guidelines recommend that women should begin cervical cancer screening approximately three years after the onset of vaginal intercourse or no later than 21 years of age, but that HPV DNA testing is not recommended in women <21 years of age. Screening recommendations are also provided for women who have received HPV vaccination.

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