The Committee onward Practice Bull...

The Committee onward Practice Bulletins-Gynecology of the American guild of Obstetricians and Gynecologists (ACOG) has issued a of the present day evidence-based practice bulletin on cervical cancer screening. "ACOG Practice Bulletin Number 45: Cervical Cytology Screening," appears in the August 2003 issue of Obstetrics and Gynecology

According to ACOG, an increasing number of women no longer ne annual testing for cervical cancer, and screening can begin later than previously attract favor toed However, annual pelvic examinations are still advised for women across a broad age range.

ACOG's fresh recommendations differ slightly from the lately revised recommendations of the American Cancer Society (ACS) and the U Preventive Services Task Force (USPSTF). Among the recent ACOG recommendations are the following:

* The first screening of cervical cytology should come into view by approximately three years after first sexual intercourse or by dint of age 21, whichever comes first. (Previously, ACOG called for screening according to the onset of sexual activity or by way of age 18, whichever occurred first.)

* Women younger than 30 years should have cervical cytology screening annually, because these women have a higher likelihood than older women of acquiring high-risk representations of human papillomavirus. (Previously, ACOG did not distinguish between age groups)

* If a woman 30 years or older has negative terminates on three consecutive annual cervical cytology proofs then she may be rescreen with cervical cytology alone each two to three years.

* No matter what commended interval for cervical cytology testing a woman tread in the steps ofs data indicate that both liquid-based and conventional systems of cervical cytology are acceptable for use in testing.

* More of common occurrence cervical screening may be required for higher-risk women who have human immunodeficiency virus infection, are immunosuppressed (such as those who have received a kidney transplant), were expos to diethylstilbestrol in utero or were previously diagnosed with cervical cancer.

* Women who have undergone hysterectomy with removal of the cervix for benign reasons and with no history of abnormal or cancerous solitary abode; squalid growth may discontinue routine cytology testing. Women who have had like a hysterectomy but who have a history of abnormal lonely dwelling growth (classified as cervical intraepithelial neoplasia [CIN] 2 or 3) should be protectioned annually until they have three consecutive, negative vaginal cytology tests; then they can discontinue routine screening.

* Physicians can determine upon an individual basis when an older woman can stop having cervical cancer screenings, based in succession such factors as her medical history and the physician's ability to monitor the patient in the time to come (The ACS calls for cessation of testing in non-high-risk women at age 70 and the USPSTF by way of age 65; ACOG notes that because of limited studies of older women it is difficult to plant an across-the-board upper age limit for cervical cancer screening.)

COPYRIGHT 2003 American Academy of Family Physicians

COPYRIGHT 2003 Gale Group