Choosing Wisely:

Don’t perform low-risk human papillomavirus (HPV) testing.

Rationale and Comments: National guidelines provide for HPV testing in patients with certain abnormal Pap smears and in other select clinical indications. The presence of high-risk HPV leads to more frequent examination or more aggressive investigation (e.g., colposcopy and biopsy). There is no medical indication for low-risk HPV testing (HPV types that cause genital warts or very minor cell changes on the cervix) because the infection is not associated with disease progression and there is no treatment or therapy change indicated when low-risk HPV is identified.
Sponsoring Organizations:
  • American Society for Clinical Pathology
  • Sources:
  • ACS/ASCCP/ASCP guidelines
  • Disciplines:
  • Gynecologic
  • References: • Lee JW, et al. Low-risk human papillomavirus testing and other non-recommended human papillomavirus testing practices among U.S. health care providers. Obstet Gynecol. 2011;118(1):4-13.
    • Saslow D, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. Am J Clin Pathol. 2012;137:516-42.
    • Zhao C, et al. Follow-up outcomes for a large cohort of U.S. women with negative imaged liquid-based cytology finding sand positive high risk human papillomavirus test results. Gynecol Oncol. 2011;122:291-6.
    • American Society for Colposcopy and Cervical Pathology. Descriptions of new FDA-approved HPV DNA tests. HPV genotyping clinical update. 2009. website/ASCCPHPVUpdate.pdf.

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