Cervical Cancer Screening Guidelines for Young Women

Screening Recommendations

The American College of Obstetricians and Gynecologists recommends that a 24-year-old woman with resolved HPV should return to routine screening in 3 years with either Pap testing alone or HPV testing with or without concurrent Pap testing 1
The risk-based management guidelines suggest that management decisions are based on current risk for CIN3+, not simply on individual test results, as recommended by the American Society for Colposcopy and Cervical Pathology (ASCCP) 1

A normal Pap smear with negative HPV testing represents the lowest risk category for cervical neoplasia, according to the Centers for Disease Control and Prevention (CDC) 1
Previous positive HPV (non-16/18) with current clearance indicates a return to baseline risk, as stated by the National Comprehensive Cancer Network (NCCN) 2, 3
At 24 years old, this patient falls into the age group where conservative management is appropriate, as many HPV infections and even high-grade lesions are transient and destined to regress, according to the NCCN 2, 3

The patient should return in 3 years for repeat screening, as recommended by the CDC 1
Screening can be performed with HPV testing with or without concurrent Pap testing, according to the ASCCP 1
If using Pap testing alone, a 3-year interval is still appropriate given the negative HPV result, as stated by the CDC 1

Five-year intervals are only appropriate for women 30 years and older with negative cotesting, as recommended by the CDC and NCCN 1, 3
Colposcopy is not indicated for this patient because current results are completely normal and previous HPV was not types 16 or 18, according to the ASCCP and NCCN 1, 3