Cervical Cancer Screening Saves Lives!

The Importance of Screening With Co-Testing

Each year, approximately 12,000 women are diagnosed with cervical cancer.1 While all women are at risk, women over the age of 30 are especially vulnerable to this disease. However, with regular screening, cervical cancer is the easiest type of gynecologic cancer to prevent and, when discovered early, is one of the most curable cancers.2

Cervical Cancer Screening Today

Women can be screened for cervical cancer in several different ways: A Pap test, an HPV test and, most commonly, a combination of the two known as co-testing.

Pap Test

A Pap test is used to find cell changes or abnormal cells in the cervix (these abnormal cells may be pre-cancer or cancer, but they may also be other things, too). Cells are lightly scraped or brushed off the cervix. They are sent to a lab and looked at under a microscope to see if the cells are normal or if changes can be seen. The Pap test is a very good test for finding cancer cells and cells that might become cancer.3

HPV Test

Similar to the pap test, the HPV test can be performed in a doctor’s office or clinic.4 An HPV test can be done using the same sample from the Pap test or by collecting a second sample from the cervical canal. The HPV test checks for the human papillomavirus virus, a virus that can cause cell changes in the cervix.5 About 10 percent of women with high-risk HPV on their cervix will develop long-lasting HPV infections that put them at risk for cervical cancer.6


Co-testing involves getting an HPV test along with the Pap test at the same time. Co-testing is the preferred way to find early cervical cancers or pre-cancers in women 30 and older. Evidence-based guidelines developed by the American College of Obstetricians and Gynecologists (ACOG), the American Society for Colposcopy and Cervical Pathology (ASCCP), the American Society for Clinical Pathology (ASCP), and the American Cancer Society support co-testing as the current standard of care.7-10

Why NPWH Recommends Co-Testing (Pap and HPV tests combined)

We believe co-testing is the most effective strategy for early disease detection.

  • Large peer-reviewed published studies in the United States indicate that co-testing identifies significantly more cervical pre-cancer and cancer than either test used alone.11,12

  • Co-testing has been shown to identify 94.5% of all cervical cancers.13

  • Recent data also support the enhanced benefits of co-testing every three years.13,14 Most clinicians and nurse practitioners today recommend co-testing every three years for patients.15,16

Cervical Cancer Screening Guidelines:
The Recent Fight to Protect Co-Testing

In September 2017, the U.S. Preventive Services Task Force (USPSTF) released draft recommendations for cervical cancer screening that recommended single testing for women between 30-65 but did not include co-testing.17 We disagreed with the guidelines for several reasons.

  • We believe without co-testing, there would be more cancers missed that could have been detected and treated earlier. In our clinical experience, we know co-testing saves lives.

  • We also had concerns about the analysis of the literature, as many studies reviewed were conducted outside of the United States and used non-FDA-approved technology. Overall, we felt the analysis was not representative of U.S. women.

  • Finally, we were concerned that health plans could drop co-testing as a preventive health care benefit available to women, creating cost barriers for many women.

Thanks in part to the outcry from many professional women’s health organizations including NPWH, the final guidelines published in August, 2018 included co-testing with an A rating. This means that today, the USPSTF continues to recommend co-testing as a preventive screening and that it will be covered by insurance.

Leading Experts Support Co-Testing



    Position Statement on Cervical Cancer Screening.


  • Infographic

    Key Facts and Figures: Cervical Cancer Screening Today

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Concerned? Here’s How You Can Help

NPWH issued a statement expressing our apprehension about the removal of co-testing in the USPSTF guidelines.

We encourage you to reach out to your Members of Congress and urge them to act.


Look up your members of Congress here


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Contact your members of Congress directly, or call 202-224-3121 and ask to be connected to their office

Share your perspective on why co-testing is vital to your patients and explain that women in [district/city/state] and across the United States deserve access to the standard of care that is recommended by clinical and cancer prevention organizations including the NPWH, the American Cancer Society, the American College of Obstetricians and Gynecologists and other leading groups. If you reach a voicemail, be sure to leave a message and remind them that you are a constituent.

Learn more about the National Association of Nurse Practitioners in Women's Health

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