{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T23:58:34Z","timestamp":1793836714039,"version":"4.6.1"},"reference-count":73,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Cervical cancer remains one of the main causes of female mortality, especially in middle- and low-income countries, despite efforts towards the implementation of global vaccination against human papillomavirus (HPV). The aim of this study was to review and compare the most recently published international guidelines providing recommendations on cervical cancer screening strategies among average and high-risk women. Thus, a comparative review of guidelines by the US Preventive Services Task Force (USPSTF), the American Cancer Society (ACS), the American Society of Clinical Oncology (ASCO), the World Health Organization (WHO), the Canadian Task Force on Preventive Health Care (CTFPHC), the Cancer Council Australia (CCA), and the European Guidelines (EG) was conducted. There is an overall agreement regarding the suggestions made for women younger than 21 and those older than 65, with all guidelines stating against routine screening, with the exceptions of CTFPHC and CCA that expand the age group to up to 70 and 75 years, respectively. Continuation of screening in older women is also suggested in those with a history of a precancerous lesion and those with inadequate screening. Most guidelines recommend routine screening at 30\u201365 years, while the WHO advises that screening should be prioritized at 30\u201349 years. HPV DNA testing is the method of choice recommended by most guidelines, followed by cytology as an alternative, except for CTFPHC, which refers to cytology only, with self-sampling being an acceptable method by most medical societies. Agreements exist regarding recommendations for specific groups, such as women with a history of total hysterectomy for benign reasons, women with a complete vaccination against HPV, individuals from the lesbian, gay, bisexual, transgender, and queer communities and women with multiple sexual partners or early initiation of sexual activity. On the other hand, the age group of 21\u201329 is addressed differently by the reviewed guidelines, while differentiations also occur in the screening strategies in cases of abnormal screening results, in women with immunodeficiency, those with in utero exposure to diethylstilbestrole and pregnant women. The development of consistent practice protocols for the most appropriate cervical cancer screening programs seems to be of major importance to reduce mortality rates and safely guide everyday clinical practice.<\/jats:p>","DOI":"10.3390\/cancers17132072","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T11:23:24Z","timestamp":1750418604000},"page":"2072","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Screening for Cervical Cancer: A Comprehensive Review of Guidelines"],"prefix":"10.3390","volume":"17","author":[{"given":"Evgenia","family":"Zampaoglou","sequence":"first","affiliation":[{"name":"Department of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eirini","family":"Boureka","sequence":"additional","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3010-5677","authenticated-orcid":false,"given":"Evdoxia","family":"Gounari","sequence":"additional","affiliation":[{"name":"Department of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Polyxeni-Natalia","family":"Liasidi","sequence":"additional","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Kalogiannidis","sequence":"additional","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9626-9295","authenticated-orcid":false,"given":"Zoi","family":"Tsimtsiou","sequence":"additional","affiliation":[{"name":"Department of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5100-8799","authenticated-orcid":false,"given":"Anna-Bettina","family":"Haidich","sequence":"additional","affiliation":[{"name":"Department of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4337-7871","authenticated-orcid":false,"given":"Ioannis","family":"Tsakiridis","sequence":"additional","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2863-5839","authenticated-orcid":false,"given":"Themistoklis","family":"Dagklis","sequence":"additional","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e191","DOI":"10.1016\/S2214-109X(19)30482-6","article-title":"Estimates of incidence and mortality of cervical cancer in 2018: A worldwide analysis","volume":"8","author":"Arbyn","year":"2020","journal-title":"Lancet Glob. Health"},{"key":"ref_2","first-page":"319","article-title":"Cervical Cancer Prevalence, Incidence and Mortality in Low and Middle Income Countries: A Systematic Review","volume":"19","author":"Shrestha","year":"2018","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Olusola, P., Banerjee, H.N., Philley, J.V., and Dasgupta, S. (2019). Human Papilloma Virus-Associated Cervical Cancer and Health Disparities. Cells, 8.","DOI":"10.3390\/cells8060622"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e161","DOI":"10.1016\/S2214-109X(20)30459-9","article-title":"Estimates of the global burden of cervical cancer associated with HIV","volume":"9","author":"Stelzle","year":"2021","journal-title":"Lancet Glob. Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"102630","DOI":"10.1016\/j.jogoh.2023.102630","article-title":"Late cervical and vaginal clear cell adenocarcinoma in women exposed in utero to diethylstilbestrol: Evaluation and screening","volume":"52","author":"Tournaire","year":"2023","journal-title":"J. Gynecol. Obstet. Hum. Reprod."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1001\/jama.2023.13174","article-title":"Cervical Cancer Screening: A Review","volume":"330","author":"Perkins","year":"2023","journal-title":"JAMA"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1093\/jjco\/hyz161","article-title":"A comparison of liquid-based and conventional cytology using data for cervical cancer screening from the Japan Cancer Society","volume":"50","author":"Ito","year":"2020","journal-title":"JPN J. Clin. Oncol."},{"key":"ref_8","first-page":"261","article-title":"The clinical utility of HPV DNA testing in cervical cancer screening strategies","volume":"130","author":"Bhatla","year":"2009","journal-title":"Indian J. Med. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.1002\/ijc.34384","article-title":"Performance of visual inspection of the cervix with acetic acid (VIA) for triage of HPV screen-positive women: Results from the ESTAMPA study","volume":"152","author":"Baena","year":"2023","journal-title":"Int. J. Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e070115","DOI":"10.1136\/bmj-2022-070115","article-title":"Human papillomavirus vaccination and cervical cancer risk","volume":"379","author":"Rahangdale","year":"2022","journal-title":"BMJ"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"A1","DOI":"10.1016\/j.vaccine.2022.02.074","article-title":"HPV vaccine introduction and implementation in Low- and Middle-Income Countries","volume":"40","author":"Denny","year":"2022","journal-title":"Vaccine"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1001\/jama.2018.10897","article-title":"Screening for Cervical Cancer: US Preventive Services Task Force Recommendation Statement","volume":"320","author":"Curry","year":"2018","journal-title":"JAMA"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"321","DOI":"10.3322\/caac.21628","article-title":"Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society","volume":"70","author":"Fontham","year":"2020","journal-title":"CA Cancer J. Clin."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e2200217","DOI":"10.1200\/GO.22.00217","article-title":"Secondary Prevention of Cervical Cancer: ASCO Resource-Stratified Guideline Update","volume":"8","author":"Shastri","year":"2022","journal-title":"JCO Glob. Oncol."},{"key":"ref_15","unstructured":"World Health Organization (2021). WHO Guideline for Screening and Treatment of Cervical Pre-Cancer Lesions for Cervical Cancer Prevention, World Health Organization. WHO Guidelines Approved by the Guidelines Review Committee."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1503\/cmaj.113-2136","article-title":"Recommendations on screening for cervical cancer","volume":"185","author":"Dickinson","year":"2013","journal-title":"CMAJ"},{"key":"ref_17","unstructured":"Cancer Council Australia (2022). Guidelines for the Management of Screen-Detected Abnormalities, Screening in Specific Populations and Investigation of Abnormal Vaginal Bleeding, Cancer Council Australia."},{"key":"ref_18","unstructured":"Anttila, A., Arbyn, A., De Vuyst, H.Y., Dillner, J., Dillner, L., Franceschi, S., Patnick, J., Ronco, G., Segnan, N., and Suonio, E. (2015). Executive Summary. European Guidelines for Quality Assurance in Cervical Cancer Screening, Office for Official Publications of the European Union. [2nd ed.]. Supplements."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1111\/aogs.14482","article-title":"High-risk HPV testing vs liquid-based cytology for cervical cancer screening among 25- to 30-year-old women: A historical cohort study","volume":"102","author":"Feldstein","year":"2023","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1158\/1055-9965.EPI-20-1003","article-title":"Cervical Cancer Screening: Comparison of Conventional Pap Smear Test, Liquid-Based Cytology, and Human Papillomavirus Testing as Stand-alone or Cotesting Strategies","volume":"30","author":"Liang","year":"2021","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1038\/sj.bjc.6606040","article-title":"The effect of self-sampled HPV testing on participation to cervical cancer screening in Italy: A randomised controlled trial (ISRCTN96071600)","volume":"104","author":"Marsili","year":"2011","journal-title":"Br. J. Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"c1040","DOI":"10.1136\/bmj.c1040","article-title":"HPV testing on self collected cervicovaginal lavage specimens as screening method for women who do not attend cervical screening: Cohort study","volume":"340","author":"Heideman","year":"2010","journal-title":"BMJ"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/S1470-2045(13)70570-9","article-title":"Accuracy of human papillomavirus testing on self-collected versus clinician-collected samples: A meta-analysis","volume":"15","author":"Arbyn","year":"2014","journal-title":"Lancet Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"k4823","DOI":"10.1136\/bmj.k4823","article-title":"Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: Updated meta-analyses","volume":"363","author":"Arbyn","year":"2018","journal-title":"BMJ"},{"key":"ref_25","first-page":"Cd002834","article-title":"Interventions targeted at women to encourage the uptake of cervical screening","volume":"2011","author":"Everett","year":"2011","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"641","DOI":"10.7326\/0003-4819-136-9-200205070-00006","article-title":"Interventions that increase use of adult immunization and cancer screening services: A meta-analysis","volume":"136","author":"Stone","year":"2002","journal-title":"Ann. Intern. Med."},{"key":"ref_27","unstructured":"Kulasingam, S.L., Havrilesky, L., Ghebre, R., and Myers, E.R. (2011). U. S. Preventive Services Task Force Evidence Syntheses, formerly Systematic Evidence Reviews. Screening for Cervical Cancer: A Decision Analysis for the US Preventive Services Task Force, Agency for Healthcare Research and Quality."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1177\/096914139600300307","article-title":"Relation between the incidence of invasive cervical cancer and the screening interval: Is a five year interval too long?","volume":"3","author":"Herbert","year":"1996","journal-title":"J. Med. Screen."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1001\/jama.2017.19872","article-title":"Screening for Cervical Cancer in Primary Care: A Decision Analysis for the US Preventive Services Task Force","volume":"320","author":"Kim","year":"2018","journal-title":"JAMA"},{"key":"ref_30","unstructured":"(2021). Syntheses of Evidence. WHO Guideline for Screening and Treatment of Cervical Pre-Cancer Lesions for Cervical Cancer Prevention, World Health Organization. [2nd ed.]. Web Annex A."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"a1754","DOI":"10.1136\/bmj.a1754","article-title":"Long term predictive values of cytology and human papillomavirus testing in cervical cancer screening: Joint European cohort study","volume":"337","author":"Dillner","year":"2008","journal-title":"BMJ"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1158\/1055-9965.EPI-11-0206","article-title":"A long-term prospective study of type-specific human papillomavirus infection and risk of cervical neoplasia among 20,000 women in the Portland Kaiser Cohort Study","volume":"20","author":"Schiffman","year":"2011","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1097\/AOG.0b013e31826e4609","article-title":"Cervical carcinoma rates among young females in the United States","volume":"120","author":"Benard","year":"2012","journal-title":"Obstet. Gynecol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.ajog.2004.01.043","article-title":"Diagnoses and outcomes in cervical cancer screening: A population-based study","volume":"191","author":"Insinga","year":"2004","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1097\/OGX.0000000000001023","article-title":"Preterm Labor: A Comprehensive Review of Guidelines on Diagnosis, Management, Prediction and Prevention","volume":"77","author":"Giouleka","year":"2022","journal-title":"Obstet. Gynecol. Surv."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1002\/ijc.30454","article-title":"HPV for cervical cancer screening (HPV FOCAL): Complete Round 1 results of a randomized trial comparing HPV-based primary screening to liquid-based cytology for cervical cancer","volume":"140","author":"Ogilvie","year":"2017","journal-title":"Int. J. Cancer"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/S1470-2045(09)70360-2","article-title":"Efficacy of human papillomavirus testing for the detection of invasive cervical cancers and cervical intraepithelial neoplasia: A randomised controlled trial","volume":"11","author":"Ronco","year":"2010","journal-title":"Lancet Oncol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1097\/OGX.0000000000001182","article-title":"Cervical Cerclage: A Comprehensive Review of Major Guidelines","volume":"78","author":"Giouleka","year":"2023","journal-title":"Obstet. Gynecol. Surv."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.ygyno.2014.12.022","article-title":"Use of primary high-risk human papillomavirus testing for cervical cancer screening: Interim clinical guidance","volume":"136","author":"Huh","year":"2015","journal-title":"Gynecol. Oncol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1002\/ijc.30551","article-title":"To expand coverage, or increase frequency: Quantifying the tradeoffs between equity and efficiency facing cervical cancer screening programs in low-resource settings","volume":"140","author":"Campos","year":"2017","journal-title":"Int. J. Cancer"},{"key":"ref_41","first-page":"111","article-title":"Efficacy of screening in preventing invasive cervical cancer: A case-control study in Milan, Italy","volume":"76","author":"Berrino","year":"1986","journal-title":"IARC Sci. Publ."},{"key":"ref_42","unstructured":"Canadian Partnership Against Cancer (2011). Cervical Cancer Screening in Canada Monitoring Program Performance, The Partnership."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/S0140-6736(20)30157-4","article-title":"Mortality impact of achieving WHO cervical cancer elimination targets: A comparative modelling analysis in 78 low-income and lower-middle-income countries","volume":"395","author":"Canfell","year":"2020","journal-title":"Lancet"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1097\/AOG.0b013e31818f5008","article-title":"Evidence for frequent regression of cervical intraepithelial neoplasia-grade 2","volume":"113","author":"Castle","year":"2009","journal-title":"Obstet. Gynecol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2946","DOI":"10.1002\/cncr.23747","article-title":"Total burden and incidence of in situ and invasive cervical carcinoma in Michigan, 1985\u20132003","volume":"113","author":"Copeland","year":"2008","journal-title":"Cancer"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1093\/jnci\/djn099","article-title":"Screening-preventable cervical cancer risks: Evidence from a nationwide audit in Sweden","volume":"100","author":"Andrae","year":"2008","journal-title":"J. Natl. Cancer. Inst."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1093\/ije\/dyg081","article-title":"Limited Pap screening associated with reduced risk of cervical cancer in South Africa","volume":"32","author":"Hoffman","year":"2003","journal-title":"Int. J. Epidemiol."},{"key":"ref_48","unstructured":"American Cancer Society (2020). American Cancer Society Cancer Prevention and Early Detection Facts and Figures, Tables & Figures 2020, American Cancer Society."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1016\/S0002-9378(99)70601-0","article-title":"The effect of hysterectomy on the risk of an abnormal screening Papanicolaou test result","volume":"180","author":"Fox","year":"1999","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1056\/NEJM199611213352103","article-title":"Cytopathological findings on vaginal Papanicolaou smears after hysterectomy for benign gynecologic disease","volume":"335","author":"Pearce","year":"1996","journal-title":"N. Engl. J. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1136\/bmj.39363.471806.BE","article-title":"Long term risk of invasive cancer after treatment for cervical intraepithelial neoplasia grade 3: Population based cohort study","volume":"335","author":"Strander","year":"2007","journal-title":"BMJ"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e020484","DOI":"10.1136\/bmjopen-2017-020484","article-title":"Community-based HPV self-collection versus visual inspection with acetic acid in Uganda: A cost-effectiveness analysis of the ASPIRE trial","volume":"8","author":"Mezei","year":"2018","journal-title":"BMJ Open"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e015048","DOI":"10.1136\/bmjopen-2016-015048","article-title":"Cost-effectiveness of HPV-based cervical cancer screening in the public health system in Nicaragua","volume":"7","author":"Campos","year":"2017","journal-title":"BMJ Open"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1093\/jnci\/djn044","article-title":"Rapid clearance of human papillomavirus and implications for clinical focus on persistent infections","volume":"100","author":"Schiffman","year":"2008","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_55","unstructured":"National Cervical Screening Program (NCSP) (2020). National Cancer Screening Register (NCSR)."},{"key":"ref_56","unstructured":"Simms, K., Hall, M., Smith, M., Lew, J.-B., Hughes, S., and Yuill, S. (2025, March 23). Management of Intermediate Risk Women After Primary HPV Testing for Cervical Screening: Evaluation of Optimal Management Strategies for the National Cervical Screening Program in Australia. Available online: https:\/\/assets-au-01.kc-usercontent.com\/59e62872-3ec4-02cb-f1dd-a1d60d76195d\/938aa15f-8c24-46f8-9ece-a45633c1df93\/Modelling_report_q1a_and_q1b.pdf."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1038\/sj.bjc.6600688","article-title":"Human papillomavirus types in invasive cervical cancer worldwide: A meta-analysis","volume":"88","author":"Clifford","year":"2003","journal-title":"Br. J. Cancer"},{"key":"ref_58","unstructured":"Medical Services Advisory Committee (2025, March 25). National Cervical Screening Program renewal: Effectiveness Modelling and Economic Evaluation in the Australian Setting. Technical Report, MSAC Application 1276, Available online: https:\/\/www.msac.gov.au\/applications\/1276."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.ygyno.2012.04.037","article-title":"Screening history preceding a diagnosis of cervical cancer in women age 65 and older","volume":"126","author":"Dinkelspiel","year":"2012","journal-title":"Gynecol. Oncol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/0029-7844(95)00472-6","article-title":"Significance of mild cytologic atypia in women infected with human immunodeficiency virus","volume":"87","author":"Wright","year":"1996","journal-title":"Obstet. Gynecol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2337","DOI":"10.1097\/01.aids.0000253361.63578.14","article-title":"Human papillomavirus types among women infected with HIV: A meta-analysis","volume":"20","author":"Clifford","year":"2006","journal-title":"Aids"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2823","DOI":"10.1001\/jama.296.23.2823","article-title":"Cancer incidence before and after kidney transplantation","volume":"296","author":"Vajdic","year":"2006","journal-title":"JAMA"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1002\/tera.1420510609","article-title":"Teratogen update: Carcinogenesis and teratogenesis associated with exposure to diethylstilbestrol (DES) in utero","volume":"51","author":"Mittendorf","year":"1995","journal-title":"Teratology"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"102042","DOI":"10.1016\/j.jogoh.2020.102042","article-title":"Screening for cancers of the cervix and vagina for women exposed to diethylstilbestrol (DES) in utero","volume":"50","author":"Tournaire","year":"2021","journal-title":"J. Gynecol. Obstet. Hum. Reprod."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/j.bpobgyn.2011.05.008","article-title":"Colposcopy in special circumstances: Pregnancy, immunocompromise, including HIV and transplants, adolescence and menopause","volume":"25","author":"Walker","year":"2011","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1111\/aogs.12138","article-title":"Colposcopically directed cervical biopsy during pregnancy; minor surgical and obstetrical complications and high rates of persistence and regression","volume":"92","author":"Strander","year":"2013","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"113.e1","DOI":"10.1016\/j.ajog.2010.04.016","article-title":"Cervical dysplasia in pregnancy: A multi-institutional evaluation","volume":"203","author":"Fader","year":"2010","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1111\/jog.12545","article-title":"Abnormal cervicovaginal cytology, unsatisfactory colposcopy and the use of vaginal estrogen cream: An observational study of clinical outcomes for women in low estrogen states","volume":"41","author":"Richards","year":"2015","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1111\/j.1471-0528.2002.01053.x","article-title":"High incidence of cervical human papillomavirus infection in women during their first sexual relationship","volume":"109","author":"Collins","year":"2002","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1155\/2007\/136906","article-title":"HPV infections in adolescents","volume":"23","author":"Moscicki","year":"2007","journal-title":"Dis. Markers"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1080\/13625187.2022.2112169","article-title":"Investigation and management of abnormal uterine bleeding in reproductive-aged women: A descriptive review of national and international recommendations","volume":"27","author":"Tsakiridis","year":"2022","journal-title":"Eur. J. Contracept. Reprod. Health Care"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"2204","DOI":"10.1016\/j.fertnstert.2011.03.079","article-title":"The FIGO classification of causes of abnormal uterine bleeding in the reproductive years","volume":"95","author":"Munro","year":"2011","journal-title":"Fertil. Steril."},{"key":"ref_73","first-page":"453","article-title":"A systematic review of postcoital bleeding and risk of cervical cancer","volume":"56","author":"Shapley","year":"2006","journal-title":"Br. J. Gen. 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