Women now have the option of getting screened every three or five years for cervical cancer, depending on which type of test they use, according to new draft recommendations from the U.S. Preventive Services Task Force.

The group of independent medical experts is recommending that women 21 to 29 years old get a cervical cytology (PAP test) every three years, while women aged 30 to 65 should either continue to get screened with a Pap every three years, or opt to be tested for the high-risk human papillomavirus (HPV) every five years.

“Cervical cancer is highly curable when found and treated early,” task force member Carol Mangione, MD, MSPH, said in a release on Monday. “Most cases of cervical cancer occur in women who have not been regularly screened or treated. Therefore, making sure all women are adequately screened and treated is critical to reducing deaths from cervical cancer.”

Despite the dramatic reduction of cervical cancer by half since the Pap test was introduced 40 years ago, nearly 13,000 American women are expected to contract this type of cancer this year. Of those, 4,200 are likely to die, according to the American Cancer Society. African-American and Hispanic women are at even greater risk.

The task force is an independent, volunteer panel of national experts in prevention and evidence-based medicine whose recommendations are widely followed by physicians and policymakers. They assign each recommendation a letter grade based on the strength of the evidence — and this recommendation comes with an A.

“We now have two effective screening strategies for women over 30, either cervical cytology every three years or HPV testing every five years,” said Douglas K. Owens, vice-chairperson of the task force.

Owens, a physician, professor of Stanford Medicine and director of the Center for Health Policy and Center for Primary Care and Outcomes Research, said that in women ages 21 to 29, a substantial portion of HPV infections resolve on their own. Cervical cytology, or Pap tests, remains the recommended screening strategy in this age group.

The advisory panel recommended against screening in women younger than 21 and older than age 65 years who have been adequately screened and don’t have a history of high-risk lesions.

The task force emphasized that cervical cytology tests remain an effective method of screening for cervical cancer, but that evidence published since its 2012 found that both Pap tests and HPV testing alone are effective ways to screen for cervical cancer in women aged 30 to 65.

“So women should discuss with their health-care provider which testing strategy is best for them,” Owens said. “What’s most important is that women get screened regularly.”

The Food and Drug Administration in 2011 approved the first test for HPV screening, a DNA test that looks for 14 types of the HPV virus, including types 16 and 18, which cause about 70 percent of all cervical cancers. In 2014, the FDA determined that the HPV test could be used alone instead of alongside the Pap test, which looks for changes in cervical cells.

The task force’s draft recommendation and evidence review have been posted for public comment on its website. Public comments can be submitted through October 9.

We often speak about U.S.–Japan relations in grand terms that focus on links between our countries. But the heart of our connection is personal—innumerable interactions between Japanese and American citizens who recognize the national and the individual benefits of such links… This is what gives Japan Day its special significance.

—The Honorable Michael Armacost, former U.S. Ambassador to Japan

The Stanford Program on International and Cross-Cultural Education (SPICE) honored top students of the Reischauer Scholars Program (RSP) and Stanford e-Japan at “Japan Day 2017”—an event held at Stanford University on August 11, 2017. The RSP honorees were Tuvya Bergson-Michelson (Lick-Wilmerding High School, San Francisco, CA), Mallika Pajjuri (Dublin High School, Dublin, CA), and Evan Wright (homeschool, Greenwood, IN), and the Stanford e-Japan honorees were Reon Hiruma (Waseda University Senior High School, Tokyo), Saya Iwama (Takada High School, Mie Prefecture), Mako Matsuzaki (graduate of Keio Girls Senior High School, Tokyo), and Alisa Tanaka (graduate of Keio Girls Senior High School, Tokyo).

Japan Day 2017 began with opening remarks by the Honorable Jun Yamada, Consul General of Japan in San Francisco, who commended the students for their study of U.S.–Japan relations and underscored the importance of educational programs such as the RSP and Stanford e-Japan in strengthening cross-Pacific relations. "There is no better investment for the future of Japan–U.S. relations," he noted, "than in educating and empowering the most promising of our youth, who will become the leaders of the future."

Stanford e-Japan Instructor Waka Takahashi Brown and RSP Instructor Naomi Funahashi presented overviews of the two programs and recognized the honorees for their outstanding academic performance and research papers. The students then took to the podium one by one to present their research to an audience of over 40 people, which included the Honorable Michael Armacost (former U.S. Ambassador to Japan), Ai Hiyama (Advisor for Community Affairs, Consulate General of Japan in San Francisco), and Maiko Tamagawa (Advisor for Educational Affairs, Japan Information and Cultural Center, Consulate General of Japan in San Francisco).

The honorees’ presentations spanned a wide range of topics related to U.S.–Japan relations, including immigration, social media, LGBTQ issues, entrepreneurship, politics, cross-cultural education, and the environment. In several cases, these topics coincided closely with the work and expertise of audience members, making for fruitful conversation and welcome synergies. During his presentation on “Cross-Cultural Education: An Unconventional Path to Immigration Reform and Economic Prosperity in Japan,” Evan Wright spoke about the Japan Exchange and Teaching (JET) Program and its role in promoting grassroots and cross-cultural international exchange between Japan and other nations. Tamagawa was pleasantly surprised to hear Wright’s comments, as she oversees the JET Program at the Consulate General of Japan in San Francisco. Wright hopes to participate in the JET Program after graduating from college.

For the students, a major highlight of the day was simply the chance to meet each other in person, after interacting intensively for months in an online-only context. Seeing the students connect with each other in person was also especially gratifying for the instructors. “One of the most rewarding things for me,” commented Funahashi, “is to see the depth of the connections that are established between RSP and Stanford e-Japan students, and how much they learn from one another. In addition to discussing American and Japanese perspectives on various aspects of contemporary society, education, politics, historical memory, and diplomacy, some students develop friendships that last far beyond their participation in these courses.” Brown agreed, adding, “For my students, having the opportunity to interact with peers from the United States was one of the highlights of the program. To see all the RSP and Stanford e-Japan award winners honored at the same event was extremely rewarding.” Ambassador Armacost emphasized the importance of building real person-to-person connections, too. “Personal relationships are deepened by a shared knowledge of language, culture, and history. But they depend ultimately on awareness of the value of personal ties, a proliferation of friendships, and a sustained effort to cultivate and maintain them through events such as Japan Day.”

Following the formal program, the students and their families took a tour of Stanford University campus. Honoree Mako Matsuzaki commented on how much she enjoyed the tour and regrets not having more time to talk with her American peers. She also somewhat jokingly noted, “I can’t imagine how Stanford students can actually study very seriously with so many temptations! (The good weather, many places to nap, frisbees, cycling, and being close to beaches.)” Funahashi and Brown hope that the friendships that have blossomed among their students will continue to strengthen the ties between the United States and Japan.

SPICE has received numerous grants in support of the RSP (since its inception in 2003) from the United States-Japan Foundation, the Center for Global Partnership (The Japan Foundation), and the Japan Fund, which is administered by the Freeman Spogli Institute for International Studies at Stanford University. Stanford e-Japan (since its inception in 2015) has been supported by a grant from the United States-Japan Foundation.