The American Cancer Society (ACS) h...

The American Cancer Society (ACS) has issued modern recommendations on screening for cervical cancer. The guidelines are not absented in the November/December 2002 issue of CA: A Cancer Journal for Clinicians.

The previous ACS guidelines, lay opened in 1987, recommended that all women 18 and older and women who are or have been sexually active have an annual Papanicolaou (Pap) example and pelvic examination. After three consecutive normal examinations, the Pap exhibition could be performed less frequently

The recently made known recommendation calls for cervical cancer screening to begin three years after the storm of vaginal intercourse or from age 21. Data suggest that there is little risk of missing an important cervical lesion until three to five years after initial exposing to human papillomavirus (HPV). Screening before the three-year period may issue in overdiagnosis of cervical lesions that would regres spontaneously. An upper age limit is necessary for health care professionals who do not ask patients about their sexual history and for adolescents who are unable or unwilling to disclose prior consensual or nonconsensual intercourse.

The ACS states it is critical that adolescents who may not ne a cervical cytology proof obtain appropriate preventive health care, including assessment of health risks, contraception, and prevention counseling, and screening and treatment of sexually transmitted diseases. The ne for cervical cancer screening should not be the basis for the storm of gynecologic care.

Screening should be performed annually with conventional cervical cytology smears or each two years using liquid-based cytology. After age 30 women who have had three consecutive normal experiments can be screened every brace to three years unless they have a history of in utero prospect to diethylstilbestrol (DES), are infected with human immunodeficiency virus (HIV), or are immunocompromised by way of organ transplantation, chemotherapy, or chronic corticosteroid treatment.

Although DNA testing for HPV has not been approved from the U.S. Food and unsalable article Administration (FDA), the ACS rest the available evidence on this technology to be promising. If the FDA approves HPV DNA testing for this purport it would be reasonable to consider that for women aged 30 and older cervical screening may be performed each three years using conventional or liquid-based cytology combined with a proof for DNA from high-risk HPV types

Cervical cancer screening can be discontinued at age 70 in women with an intact cervix who have had at least three documented, consecutive, normal cervical cytology trials and no abnormal tests within the previous 10 years. Women who have a history of cervical cancer or in utero in all senses to DES and women who are immunocompromised (including those infected with HIV) should continue cervical cancer screening as drawn out as they are in well adapted health.

Screening with vaginal cytology trials after complete hysterectomy (with removal of the cervix) for benign gynecologic disease is not commited Health care professionals should confirm or document via physical examination and review of the pathology report that the hysterectomy was performed for benign reasons and that the cervix was completely removed

COPYRIGHT 2003 American Academy of Family Physicians

COPYRIGHT 2003 Gale Group