Table 2

Recommended levels for evidence-based recommendations.

Cervical Cancer Screening Methods

Recommendation level

HPV test

High-risk HPV testing is recommended as the preferred method for primary screening, using HPV assays that are recognized by domestic and international authoritative institutions and clinically validated for primary screening.

1

Cytology

In areas where high-risk HPV testing is not available, cervical cytology is recommended. When conditions are favorable, screening methods based on high-risk HPV testing should be adopted.

2A

Cotesting

It is recommended to use cervical cancer screening for women in regions with sufficient healthcare resources, opportunistic screening populations, and partial special populations

1

Visual inspection

It is recommended to use cervical cancer screening in areas with limited healthcare resources where HPV testing or cytology is not available

2B

Screening recommendations for different populations

General Population

Screening initiation age: Women aged 25; Women aged 25–64: HPV testing every 5 years, or cotesting, or cytology testing every 3 years; Screening termination age: Women aged> 65, with previous adequate screening historya

1

Special Populations

High-risk females under 25 years old

Early screening is recommended and shortening the screening interval appropriately

2B

Pregnant womenb

It is recommended to perform cervical cancer screening before or during pregnancy. The screening method can be either cytology alone or a cotesting

2A

Women after hysterectomy

A. Hysterectomy due to cervical abnormalities

It is recommended to undergo cotesting annually. If three consecutive cotesting yield negative results, the screening interval can be extended to every 3 years, and this should be continued for 25 years

2A

B. Hysterectomy due to benign uterine diseases (non-cervical abnormalities)

If there are no suspicious clinical symptoms or signs, routine screening is not recommended. For patients with unclear preoperative cervical lesions before hysterectomy, if there are clinically suspicious symptoms or signs, it is recommended cotesting.

2B

Immunocompromised women who are sexually active

It is recommended to screen sexually active immunocompromised females as early as possible, following the screening strategy for HIV-infected populations

2A

Preventive HPV vaccination

The screening strategy is the same for individuals who have not received the HPV vaccine.

2B

  • a Adequate screening history: Within the past 10 years, having had three consecutive cytology screenings, or two consecutive HPV screenings or cotestings, with the most recent screening within 5 years, and all screening results being normal. Additionally, there should be no history of CIN (cervical intraepithelial neoplasia), persistent HPV infection, or high-risk factors such as treatment for HPV-related diseases.

  • b Women who have never undergone cervical cancer screening;