ISCCP –Recommendations for Cervical Cancer Screening

  1. Screening should be opportunistic in all patients coming with any gynae problem.

  2. Age of starting screening should be 21 years.

  3. Screening should be done at least once every decade.

  4. In the age group of 21-30 years, VIA/PAP should be done & repeated 3 yearly if possible.

  5. In the age group of 31-40 years, VIA/PAP should be the primary modality. HPV could be used for riage if resources are available.

  6. 41-50 – VIA/PAP should be used (If post-menopausal Pap alone should be used)

  7. 51-60 years – Screening should be by HPV or Pap

  8. If the Pap smear is abnormal, the woman should be referred for Colposcopy and further treatment if feasible.

  9. If Colposcopy is not feasible, VIA should be done after applying 5% acetic acid. If on VIA, an acetowhite area is seen, cryotherapy should be performed after taking a punch biopsy provided the squamocolumnar junction is visible. If the SCJ is not visible, the woman should be referred for Loop Electrosurgical Excision of the Transformation Zone at the nearest centre.