text: The American Cancer Society Guidelines for the Prevention and Early Detection of Cervical Cancer 
   
   The American Cancer Society recommends that women follow these guidelines to help find cervical cancer early. Following these guidelines can also find pre-cancers, which can be treated to keep cervical cancer from forming. All women should begin cervical cancer testing (screening) at age 21. Women aged 21 to 29, should have a Pap test every 3 years. HPV testing should not be used for screening in this age group (it may be used as a part of follow-up for an abnormal Pap test). 
   
   Beginning at age 30, the preferred way to screen is with a Pap test combined with an HPV test every 5 years. This is called co-testing and should continue until age 65. 
   
   Another reasonable option for women 30 to 65 is to get tested every 3 years with just the Pap test. 
   
   Women who are at high risk of cervical cancer because of a suppressed immune system (for example from HIV infection, organ transplant, or long-term steroid use) or because they were exposed to DES in utero may need to be screened more often. They should follow the recommendations of their health care team. 
   
   Women over 65 years of age who have had regular screening in the previous 10 years should stop cervical cancer screening as long as they haven’t had any serious pre-cancers (like CIN2 or CIN3) found in the last 20 years (CIN stands for cervical intraepithelial neoplasia and is discussed later in the section Work-up of an abnormal Pap test result under the heading How biopsy results are reported). Women with a history of CIN2 or CIN3 should continue to have testing for at least 20 years after the abnormality was found. 
   
   Women who have had a total hysterectomy (removal of the uterus and cervix) should stop screening (such as Pap tests and HPV tests), unless the hysterectomy was done as a treatment for cervical pre-cancer (or cancer). Women who have had a hysterectomy without removal of the cervix (called a supra-cervical hysterectomy) should continue cervical cancer screening according to the guidelines above. 
   
   Women of any age should NOT be screened every year by any screening method. 
   
   Women who have been vaccinated against HPV should still follow these guidelines. Some women believe that they can stop cervical cancer screening once they have stopped having children. This is not true. They should continue to follow American Cancer Society guidelines. Although annual (every year) screening should not be done, women who have abnormal screening results may need to have a follow-up Pap test (sometimes with a HPV test) done in 6 months or a year. The American Cancer Society guidelines for early detection of cervical cancer do not apply to women who have been diagnosed with cervical cancer, cervical pre-cancer, or HIV infection. These women should have follow-up testing and cervical cancer screening as recommended by their health care team. Importance of being screened for cervical cancer 
   
   Cervical cancer was once one of the most common causes of cancer death for American women. The cervical cancer death rate dropped significantly with the increased use of the Pap test for screening. But the death rate has not changed much over the last 15 years. 
   
   Screening tests offer the best chance to have cervical cancer found early when successful treatment is likely. Screening can also actually prevent most cervical cancers by finding abnormal cervical cell changes (pre-cancers) so that they can be treated before they have a chance to turn into a cervical cancer. ||||| (CNN) The risk of dying from cervical cancer might be much higher than experts previously thought, and women are encouraged to continue recommended cancer screenings. 
   
   Black women are dying from cervical cancer at a rate 77% higher than previously thought, and white women are dying at a rate 47% higher, according to a study published in the journal Cancer on Monday. 
   
   The study found that previous estimates of cervical cancer death rates didn't account for women who had their cervixes removed in hysterectomy procedures, which eliminates the risk of developing the cancer. 
   
   "Prior calculations did not account for hysterectomy because the same general method is used across all cancer statistics," said Anne Rositch, assistant professor of epidemiology at Johns Hopkins Bloomberg School of Public Health in Baltimore and lead author of the study. 
   
   That method is to measure cancer's impact across a total population without accounting for factors outside of gender, she said. 
   
   There were about 12,990 new cases of cervical cancer in the United States last year and 4,120 cervical cancer deaths, according to the National Cancer Institute 
   
   'A better understanding of the magnitude' 
   
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   The data were limited to only 12 states in the country, but the researchers noted that the data still provided a nationally representative sample of women. 
   
   Then, the researchers collected data from the Behavioral Risk Factor Surveillance System on how many women in 2000 to 2012, 20 and older, reported ever having a hysterectomy. They used that data to adjust the cervical cancer deaths rates. 
   
   Before the adjustment, the data showed that the cervical cancer killed about 5.7 out of 100,000 black women and 3.2 per 100,000 white women. After adjusting for hysterectomies, the rate was 10.1 per 100,000 black women and 4.7 per 100,000 white women. 
   
   The data showed that the racial disparity seen in cervical cancer death rates for black and white women was underestimated by 44% when hysterectomies were not taken into account. 
   
   "We can't tell from our study what might be contributing to the differences in cervical cancer mortality by age and race," Rositch said. "Now that we have a better understanding of the magnitude of the problem, we have to understand the reasons underlying the problem." 
   
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   Cervical cancer is highly preventable in the United States because of the availability of screening tests and a vaccine to prevent human papillomavirus, or HPV, which can cause cervical cancer, according to the Centers for Disease Control and Prevention 
   
   "Racial disparity may be explained by lack of access or limited access to cervical cancer screening programs among black women when compared to whites," said Dr. Marcela del Carmen, a gynecologic oncologist at the Massachusetts General Hospital Cancer Center, who was not involved in the new study. 
   
   "This gap and disparity need to be addressed with initiatives focusing on better access to prevention or screening programs, better access to HPV vaccination programs and improved access and adherence to standard of care treatment for cervical cancer," she said. 
   
   The new findings add to the current understanding of cervical cancer's impact on different communities, said Dr. John Farley, a practicing gynecologic oncologist and professor at Creighton University School of Medicine at St. Joseph's Hospital and Medical Center in Arizona. 
   
   "It lets us know that there is substantial work to do to investigate and alleviate the racial minority disparity in cervical cancer in the US," said Farley, who was not involved in the study but co-authored an editorial about the new findings in the journal Cancer on Monday. 
   
   "Those who get cancer, many times, do not have access to screening," he said. 
   
   Even though cervical cancer mortality rates are higher than previously thought, Farley said that he thinks the current screening recommendations for cervical cancer are still adequate. However, he added, more women should have access to screenings and other preventive measures. 
   
   Rositch said, "It may be that some women are not obtaining screening according to our current guidelines, not necessarily that guideline-based care is insufficient." 
   
   How to prevent and screen for cervical cancer 
   
   The American Cancer Society recommends that women begin cervical cancer screenings at age 21 by having a Pap test every three years. Then, beginning at 30, women should have a Pap test combined with a HPV test every five years. However, the recommendations are not universal among all expert groups. 
   
   Symptoms of cervical cancer tend to not appear until the cancer has advanced, which is why screening and HPV vaccinations are urged. 
   
   "We have a vaccine which can eliminate cervical cancer, like polio, that is currently available, and only 40% of girls age 13 to 17 have been vaccinated," said Farley, co-author of the editorial. "This is an epic failure of our health care system in taking care of women in general and minorities specifically." 
   
   Women over 65 might not need to continue screening if they don't have a history of cervical cancer or negative Pap test results, according to the American Congress of Obstetricians and Gynecologists 
   
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   A study published in the journal JAMA Oncology last week found that among a group of 1,868 men in the United States, about 45% had genital HPV infections and only about 10% had been vaccinated. 
   
   "Male HPV vaccination may have a greater effect on HPV transmission and cancer prevention in men and women than previously estimated," the researchers wrote in that study. ||||| The death rate from cervical cancer in the United States is considerably higher than previously estimated and the disparity in death rates between black women and white women is significantly wider, according to a study published Monday in the journal Cancer. 
   
   The rate at which black American women are dying from the disease is comparable to that of women in many poor developing nations, researchers reported. What makes the findings especially disturbing, said experts not involved in the research, is that when screening guidelines and follow-up monitoring are pursued, cervical cancer is largely preventable. 
   
   “This shows that our disparities are even worse than we feared,” said Dr. Kathleen M. Schmeler, an associate professor of gynecologic oncology at the University of Texas M. D. Anderson Cancer Center. “We have screenings that are great, but many women in America are not getting them. And now I have even more concerns going forward, with the” — expected — “repeal of the Affordable Care Act, which covers screening, and the closing of family planning clinics, which do much of that screening.” 
   
   The racial disparity had been noted in earlier studies, but it had been thought to have narrowed because cervical cancer death rates for black women were declining. But this study said that the gap was far greater than believed.
target: – Many more American women are dying from cervical cancer than previously thought, with black women in particular dying at rates akin to those in sub-Saharan Africa, the New York Times reports. Although cervical cancer is highly preventable, African-American women are dying at a rate 77% higher that previously estimated, CNN reports. For white women, the rate was 47% higher. "This shows that our disparities are even worse than we feared,” Dr. Kathleen M. Schmeler tells the Times. New research in the journal Cancer excluded from death rates women who had undergone hysterectomies; previous research had included them even though they were not at risk because their cervixes were removed. Last year, there were 12,990 new cases of cervical cancer in the US, and 4,120 deaths, per the National Cancer Institute. The new study re-examined those figures. For black women, the news was shockingly bad, with 10.1 per 100,000 dying of cervical cancer (compared to 4.7 for white women), a rate seen in underdeveloped countries, per the Times. Reasons for the racial disparity included poor access to screenings and the HPV vaccine. Experts said screening options must be expanded for at-risk women, and warned that the gap could widen if the Affordable Care Act is repealed and women's health clinics shuttered. While screenings work well, "many women in America are not getting them," says Schmeler. Symptoms for cervical cancer do not appear until late, which is why the American Cancer Society recommends screenings and a pap test every three years from age 21, and every five years after age 30. (HPV-related cancer is "epidemic.")