The Centers for Medicare and Medicaid (CMS) has started the process to consider covering cervical cancer screening using a combination of HPV and Pap tests, called “co-testing.” The American Cancer Society recommends co-testing as the preferred method of cervical cancer screening for women ages 30 to 65. (Women ages 21 to 29 should not get the HPV test with the Pap test, because HPV is so common in younger women that it’s not helpful to test for it. They should have a Pap test every 3 years [at ages 21, 24, and 27] to test for cervical cancer.)
Debbie Saslow, Ph.D., director, breast and gynecologic cancer for the American Cancer Society, welcomed the development from CMS.
“We are pleased that CMS is considering covering the HPV test, which is an important preventive service. The American Cancer Society along with 25 other organizations have guidelines that are virtually identical to those from the United States Preventive Services Task Force (USPSTF), recommending “co-testing.” The one difference between the recommendations is that the Society and all of the other groups recommend HPV/Pap “co-testing” as the “preferred” strategy whereas USPSTF recommends either co-testing or Pap alone without designating one as preferred to the other.
“Based on our evidence review, we and the other organizations conclude that HPV testing (co-testing) has greater health benefits and fewer harms to women as long as screening is not performed too frequently. While the American Cancer Society did not consider cost or cost-effectiveness as part of our guideline process, we are aware that cost-effectiveness data supports co-testing.
“Together with our advocacy affiliate, the American Cancer Society Cancer Action Network (ACS CAN), we are reviewing the details of CMS proposal and considering whether to file comments, which are due by December 25th.”
Medicare currently covers a screening pelvic examination and Pap test for all female beneficiaries at 12 or 24 month intervals, based on specific risk factors. CMS does not currently include HPV testing in its coverage.