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Apr 1, 2019 Issue
HPV Vaccine for Prevention of High-Grade Precancerous Cervical Lesions [Medicine by the Numbers]
Data suggest the benefits of HPV vaccination for reducing precancerous lesions outweigh the potential harms. Find out more.
Feb 15, 2019 Issue
Screening for Cervical Cancer: Recommendation Statement [U.S. Preventive Services Task Force]
The USPSTF recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years. For women aged 30 to 65 years, the USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with high-risk human papillomavirus (hrHPV) testing al...
P.J., a 48-year-old woman, presents to your office for a well-woman examination. She has been married for eight years, has no history of sexually transmitted diseases, and has nothing remarkable in her medical history.
HPV vaccination in women 15 to 26 years of age prevents the development of cervical intraepithelial neoplasia (CIN) 2 and CIN 3 in women regardless of previous HPV exposure (number needed to treat [NNT] = 39). No serious adverse effects are associated with administration of the HPV vaccine.
In women who had received the HPV vaccine, screening for HPV every five years, with cytology and colposcopy follow-up as needed, resulted in higher rates of identification of high-grade pre-cancerous disease than standard liquid-based cytology every 2.5 years with HPV follow-up cotesting as needed.
Cervical cancer may be detected after a Papanicolaou test result is abnormal, a lesion is visualized on pelvic examination, or clinical symptoms develop. Once cervical cancer is diagnosed, treatment may involve surgery, radiation therapy, chemotherapy, or a combination. The choice of therapy depends on the stage of disease, lymph node involvement, patient comorbidities, and risk factors for recurrence.
Cervical cancer screening methods include cytology and human papillomavirus (HPV) testing. Although primary HPV testing is now considered an option, most major guidelines still recommend cytology alone or cotesting with cytology plus HPV testing. Learn which patients may benefit from screening and how to choose a screening method.
Among women 22 to 27 years of age with an index cervical cytology showing abnormal squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL), the incidence of invasive cervical cancer did not differ between repeat cytology within six months or colposcopy with biopsy within six months.
Cervical treatments for dysplasia and early cervical carcinoma are associated with subsequent risk of preterm birth. Excisional treatments carry higher risk than ablative treatments, and multiple treatments carry higher risk than single treatments. The frequency and severity of prematurity-related o...
Dec 15, 2015 Issue
ACP Releases Best Practice Advice on Screening for Cervical Cancer [Practice Guidelines]
Based on the best available evidence, the American College of Physicians (ACP) has released best practice advice on cervical cancer screening in average-risk, asymptomatic women 21 years or older. This advice is targeted to all clinicians, and refers to screening for cervical precancerous and cancer...