November 20, 2009

Dear Colleague,

The American College of Obstetricians and Gynecologists will issue revised guidelines for cervical cancer screening in the December issue of Obstetrics & Gynecology. Practice Bulletin ##109 "Cervical Cytology Screening" can be viewed now at http://www.acog.org/publications/
educational_bulletins/pb109.cfm. Unfortunately, the press broke the planned embargo before we were able to institute our communication of these new recommendations to our members.

I am sending this e-mail so you can be aware of these guidelines prior to their print publication. Important changes in the Practice Bulletin include:

• Cervical cancer screening should begin at age 21 years (regardless of sexual history). Screening before age 21 should be avoided because women less than 21 years old are at very low risk of cancer. Screening these women may lead to unnecessary and harmful evaluation and treatment.

  
  

• Cervical cytology screening is recommended every 2 years for women between the ages of 21 years and 29 years. Evidence shows that screening women every year has little benefit over screening every other year.

Further recommendations and detailed evaluation of supporting evidence for cervical cancer screening are included in Practice Bulletin ##109. The College continues to recommend the annual well-woman exam, which is not the subject of this Bulletin.

Thank you for all that you do.

Sincerely,
Gerald F. Joseph, Jr, MD
President
American College of Obstetricians and Gynecologists