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ACP91 Cervical Cancer Screening paper Embargoed Until 11 AM Eastern Thursday April 30th 2015
Embargoed Until 11 AM Eastern Thursday April 30th 2015
Slate 1
American College Of Physicians Releases
New Advice for Cervical Cancer Screening in Average Risk Women Without Symptoms
ACP’s advice is supported by ACOG and endorsed by ASCP
American College of Physicians
Video Press Kit
For More Information Please Contact:
American College of Physicians
Steve Majewski
215.351.2514 (or 617-954-3951, April 28-May 1)
SMajewski@mail.acponline.org
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Slate 2
Courtesy the American College of Physicians,
publisher of Annals of Internal Medicine.
Slate 3
Table of Contents:
Story Description
Interview ID
Suggested Lead
Full Video Package
:30 Video Package
Additional Soundbites
Additional B-Roll
Script FINAL
ACP91 Cervical Cancer Screening paper Embargoed Until 11 AM Eastern Thursday April 30th 2015
Slate 4
Story Description:
The American College of Physicians (ACP) has released clinical advice for cervical cancer screening in average risk
women without symptoms. “Cervical Cancer Screening in Average Risk Women” is published in Annals of Internal
Medicine and lists two concurring organizations: the American Congress of Obstetricians and Gynecologists and the
American Society for Clinical Pathology. ACP’s Best Practice Advice is based on a distillation of relevant publications,
including systematic reviews.
ACP’s advice for cervical cancer screening is designed to maximize the benefits and minimize the harms of testing.
Historically, physicians have low adherence to cervical cancer screening recommendations, beginning screening too
early, performing screening too often, and continuing to screen women at low risk, either by age criteria or after
hysterectomy with removal of cervix.
ACP advises that physicians should start screening average risk women for cervical cancer at age 21 once every three
years with cytology tests alone. Physicians may use a combination of cytology and HPV (human papillomavirus)
testing once every five years in average risk women age 30 and older who prefer screening less often than every three
years. Physicians should stop screening average risk women older than 65 years for cervical cancer who have had
three consecutive negative cytology results or two consecutive negative cytology plus HPV test results within 10 years
with the most recent test performed within five years.
ACP further advises that physicians should not screen average risk women younger than 21 years for cervical cancer
or screen average risk women for cervical cancer with cytology more often than once every three years. Physicians
should not perform HPV testing in average risk women younger than 30 years or screen average risk women of any
age for cervical cancer who had a hysterectomy with removal of cervix.
The harms of screening average risk women without symptoms for cervical cancer include
discomfort with speculum examinations and colposcopies, pain and bleeding with cervical biopsies
and excisional treatments, prolonged surveillance, potential adverse obstetrical outcomes with
some excisional treatments and false positive testing.
Slate 5
Interview Id
Tanveer P. Mir, MD, MACP
American College of Physicians
Clinical Guidelines Committee
Associate Professor of Medicine
Laura and Isaac Permutter Cancer Center
NYU Langone Medical Center
Script FINAL
ACP91 Cervical Cancer Screening paper Embargoed Until 11 AM Eastern Thursday April 30th 2015
Slate 6
Suggested lead in: New advice from the American College of Physicians aims to inform women
about the benefits and harms of cervical cancer screening. The group says that some women can
benefit from less screening.
Slate 7
Full package:
(1) Announcer: More testing is not always better, even
when it comes to cervical cancer screening. The
American College of Physicians has new advice on
when to start, with what test, and how often to screen
women at average risk for the disease.
Dr. Tanveer Mir
(2) Dr. Tanveer Mir: ACP’s advice is designed to
maximize the benefits and reduce the harms for
cervical screening in average risk women. What it
means is that frequency of testing, the initial testing
age, and when to stop testing are important.
Historically, physicians have started testing too
frequently, too early, and they haven't stopped at the
right time. This yields to potential of harms.
(3) Announcer: The new advice paper, published in
Annals of Internal Medicine, lists two concurring
organizations: the American Congress of Obstetricians
and Gynecologists and the American Society for
Clinical Pathology. ACP offers this advice for screening:
(4) Dr. Tanveer Mir: For women at an average risk,
ACP advises that screening start at age twenty one
with cytology for cervical cancer. Then at age thirty,
HPV, or human papilloma virus screening, and cytology
can be combined. Subsequent to that, patients can be
screened every three to five years depending on their
personal preference and this is a discussion they need
to have with their physician so that they can have a
shared decision making.
(5) Announcer: Women of any age who had a
hysterectomy with removal of cervix should not be
screened for cervical cancer. Average risk women who
are over 65 who have had several
negative test results can stop being screened.
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ACP91 Cervical Cancer Screening paper Embargoed Until 11 AM Eastern Thursday April 30th 2015
(6) Dr. Tanveer Mir: The likelihood of a woman having
an abnormal test for cervical screening depends on the
age and the frequency of the testing. ACP recommends
testing at the right age, at the right intervals, and the
right time.
(7) Announcer: The harms of unnecessary screening
can be significant
(8) Dr. Tanveer Mir: The harms of screening are
discomfort of examination and undergoing the test.
These would be pelvic discomforts, sometimes
bleeding. And then also, for women who are of younger
age, it leads to obstetric complications during delivery.
So these are unknown harms. In addition to that, overtesting has been shown to increase the procedure
rates like colposcopies, biopsies, and cone biopsies.
(9) Announcer: By following ACP’s Best Practice
Advice, physicians can practice high value care by
reducing over-screening, over treatment, and
unnecessarily higher costs.
(10) Dr. Tanveer Mir: ACP’s advice is for average risk
women who are asymptomatic to have a discussion
with the physician about the frequency of testing and
when to stop testing.
(11) Announcer: ACP’s advice applies to women
without symptoms who are at average risk, such as
those with no prior history of a precancerous lesion or
cervical cancer. For more information go to
acponline.org.
Slate 8
:30 version
(1) Announcer: More testing is not always better, even
when it comes to cervical cancer screening. The
American College of Physicians has new advice on
when to start, with what test, and how often to screen
women at average risk for the disease.
Dr. Tanveer Mir
(2) Dr. Tanveer Mir: ACP’s advice is to maximize the
benefits of cervical screening for patients. Historically,
physicians have screened too early, too frequently,
Script FINAL
ACP91 Cervical Cancer Screening paper Embargoed Until 11 AM Eastern Thursday April 30th 2015
without improving the outcomes. ACP’s advice is to
start screening at the right time, at the right intervals,
and to stop screening at the right time.
website
(3) Announcer: For more information go to
acponline.org.
Slate 9
Additional Soundbites
B-roll bites:
The ACP advice is meant for women with average risk who are asymptomatic. High risk women would be
someone with a history of cervical cancer or abnormal tests in the past. Women who are
immunocompromised, for example HIV, or women who have been exposed to DES in utero or
diethylstilbestrol.
The risk of abnormal tests in terms of cytology is significantly higher, in women below the age of twenty one
and does not lead to any significant added risk of cervical cancer in the future. So testing below the age of
twenty one has been shown to be of low value without any added benefit to the patient.
ACP best practice advice is not to screen women under the age of thirty for human papilloma virus. The
risk of false positives is significantly higher without improving the outcomes.
It is recommended that pap smears, or the cytology screening, be started at age twenty one. Not earlier.
And then to continue screening every three years or so. At age thirty, patients or women can undergo
screening with both the HPV and the cytology.
Slate 10
Additional B-roll
Slate 11
Courtesy the American College of Physicians, publisher of Annals of Internal Medicine
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