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The devil is in the details.

Get the facts. Know her risk.

Background

As a nurse practitioner or physician assistant, you play a critical role in educating, screening and counseling patients about HPV and cervical cancer. This site provides access to tips and tools that can be used with patients to facilitate discussion before and after cervical cancer screening to help you intervene for patients at all levels of care – from educating women about HPV and cervical cancer risk factors to implementing the new cervical cancer screening guidelines aimed at early detection.

With more than 12,000 women diagnosed with invasive cervical cancer annually in the United States,1 the importance of screening for high-risk HPV types that could lead to cervical cancer has been well established.

  • While the global impact of Pap testing in women’s health cannot be understated, up to one-third of cervical cancers occur in appropriately screened women with normal cytology results.2,3
  • The limitations of Pap testing may affect women at both ends of the diagnostic spectrum.
    • Women with cervical precancer who have normal cytology and go undetected with cytology alone and do not receive needed treatment.
    • Women with ASC-US cytology who may receive unnecessary interventions and treatment.

New guidelines at a glance

New cervical cancer screening guidelines announced

In March 2012, a multidisciplinary partnership between the American Cancer Society, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology released updated cervical cancer screening guidelines.4 In November 2012, the nation’s largest OB-GYN organization, the American Congress of Obstetricians and Gynecologists, separately published guidelines for cervical cancer screening that aligned with the recommendations of these groups.5

At a glance, the new ACS/ASCCP/ASCP guidelines for managing women with normal Pap cytology results recommend:4

 

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Populaton Screening Method
Women <21 years No screening
Women 21 - 29 years Screen with Pap every 3 years
Women 30-65 years HPV and cytology "co-testing" every 5 years (preferred)*
Women >65 years No screening following adequate prior normal screening results

*Cytology alone every 3 years (acceptable)

  • Acronyms:

REFERENCES:

  1. Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Can J Clin. 2010;60:277-300.
  2. Leyden WA, Manos MM, Geiger AM, et al. Cervical cancer in women with comprehensive health care access: attributable factors in the screening process. J Natl Cancer Inst. 2005;97(9):675-683.
  3. Andrae B, Kemetli L, Sparén P, et al. Screening-preventable cervical cancer risks: evidence from a nationwide audit in Sweden. J Natl Cancer Inst. 2008;100(9):622-629.
  4. Saslow D et al, Journal of Lower Genital Tract Disease, Volume 16, Number 3, 2012.
  5. The American Congress of Obstetricians and Gynecologists. ACOG Practice Bulletin. Clinical Management Guidelines for Obstetrician-Gynecologists: Screening for Cervical Cancer. November 2012.