Recommendations for a national agenda to substantially reduce cervical cancer



Prophylactic human papillomavirus (HPV) vaccines and new HPV screening tests, combined with traditional Pap test screening, provide an unprecedented opportunity to greatly reduce cervical cancer in the USA. Despite these advances, thousands of women continue to be diagnosed with and die of this highly preventable disease each year. This paper describes the initiatives and recommendations of national cervical cancer experts toward preventing and possibly eliminating this disease.


In May 2011, Cervical Cancer-Free America, a national initiative, convened a cervical cancer summit in Washington, DC. Over 120 experts from the public and private sector met to develop a national agenda for reducing cervical cancer morbidity and mortality in the USA.


Summit participants evaluated four broad challenges to reducing cervical cancer: (1) low use of HPV vaccines, (2) low use of cervical cancer screening, (3) screening errors, and (4) lack of continuity of care for women diagnosed with cervical cancer. The summit offered 12 concrete recommendations to guide future national and local efforts toward this goal.


Cervical cancer incidence and mortality can be greatly reduced by better deploying existing methods and systems. The challenge lies in ensuring that the array of available prevention options are accessible and utilized by all age-appropriate women—particularly minority and underserved women who are disproportionately affected by this disease. The consensus was that cervical cancer can be greatly reduced and that prevention efforts can lead the way towards a dramatic reduction in this preventable disease in our country.

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    In March 2012, the ASCCP/ACS/ASCP and the USPSTF included HPV testing in their updated recommendations.

  2. 2.

    The ACS/ASCCP/ASCP and the USPSTF 2012 recommend screening begin at 21 years of age.

  3. 3.

    Consistency among guidelines has been accomplished over the past year, with the American Cancer Society, the American Society for Colposcopy and Cervical Pathology and the American Society for Clinical Pathology issuing joint guidelines that are essentially the same as the newly released USPSTF guidelines. In addition, the American College of Obstetrics and Gynecologists endorsed these guidelines and is expected to update their own guidelines to match them.



Affordable Care Act of 2010


Advisory Committee on Immunization Practices


American Cancer Society


American Society for Colposcopy and Cervical Pathology


American Society for Clinical Pathology


Cervical Cancer-Free America


Centers for Disease Control and Prevention


Children’s Health Insurance Program


Food and Drug Administration


Family Education Rights and Privacy Act


Federally Qualified Health Centers


Human papillomavirus


National Breast and Cervical Cancer Early Detection Program




University of North Carolina


United States Preventive Services Task Force


Vaccines for Children


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Authors would like to thank organizations and corporations who support Cervical Cancer-Free America in its efforts to greatly reduce cervical cancer rates in the USA. Authors also would like to thank Tracy Morris and Helaine Bader for their contributions to the writing of this paper.

Conflict of interest

The Cervical Cancer-Free America launch meeting was funded by unrestricted gifts from GlaxoSmithKline, Hologic, Qiagen, and Merck Corporation. Dr. Noel T. Brewer has received research grants, served on paid advisory boards, and/or been a paid speaker for Merck and GSK. Dr. Kenneth Alexander serves on the speakers Bureau for Merck vaccines, has spoken on behalf of MSD (Merck’s European branch), for Sanofi, and also serves as a paid advisor for Merck vaccines. Dr. Richard Crosby has received research grants and been a paid advisor for Merck. Dr. Warner Huh has served as a consultant for Roche Diagnostics, Merck Corporation, and GlaxoSmithKline. Dr. Gregory D. Zimet is an investigator on research grants funded by Merck’s Investigator Initiated Science Program (MISP). Dr. Jennifer Smith has received research grants, unrestricted educational gifts, served on advisory boards, and/or has been a paid speaker for GSK, Hologic Gen-Probe, Merck and QIAGEN.

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Correspondence to Jennifer S. Smith.

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Smith, J.S., Brewer, N.T., Saslow, D. et al. Recommendations for a national agenda to substantially reduce cervical cancer. Cancer Causes Control 24, 1583–1593 (2013).

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  • Cervical cancer prevention
  • Human papillomavirus
  • HPV vaccine
  • HPV test
  • Pap test