Guidelines for the Well-Woman Exam - CME Conferences
Guidelines for the Well-Woman Exam - CME Conferences Guidelines for the Well-Woman Exam - CME Conferences
2 nd Annual Primary Care Fall Conference Wednesday, October 24, 2012Cervical CytologicScreening - In Her 20’s• Cervical cancer screening should begin atage 21 regardless of age at onset ofsexual activity.• Cervical cytology screening from age 21 to29 is recommended every 3 years butshould be more frequent in women who areHIV-positive, are immunosuppressed, wereexposed in utero to diethylstilbestrol, or havebeen treated for cervical intraepithelialneoplasia (CIN) 2, 3 or cervical cancer. ACOG Practice Bull. #431, 2009Cervical CytologicScreening• Women with histories of CIN 2+ shouldundergo annual screening for 20 yearsafter treatment.•• HPV vaccination does not changeany of the foregoing recommendations.David Plourd, MDWomen Exam
2 nd Annual Primary Care Fall Conference Wednesday, October 24, 2012Don’t Get Caught Up…Don’t Lose Perspective• The central purpose in screening isto detect HIGH GRADE LESIONS• CIN 2,3, CIS, CxCA Most LSIL, esp in young women,represents ACUTE HPV infection80% resolve by 1 year (91% by 3years) without intervention Evaluate ASC / LSIL to eval for HSIL Preventing all cervical CA’s isunattainable / undesirable2012 RevisedScreening Guidelines• GOOD news for women andproviders Simpler less frequent screening withbetter outcomes than with priorscreening techniques Allows more time for other prioritiesat the “annual visit” Less CA’s; avoiding harm• http://CAonline.AmCancerSoc.orgDavid Plourd, MDWomen Exam
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2 nd Annual Primary Care Fall Conference Wednesday, October 24, 2012Cervical CytologicScreening - In Her 20’s• Cervical cancer screening should begin atage 21 regardless of age at onset ofsexual activity.• Cervical cytology screening from age 21 to29 is recommended every 3 years butshould be more frequent in women who areHIV-positive, are immunosuppressed, wereexposed in utero to diethylstilbestrol, or havebeen treated <strong>for</strong> cervical intraepi<strong>the</strong>lialneoplasia (CIN) 2, 3 or cervical cancer. ACOG Practice Bull. #431, 2009Cervical CytologicScreening• Women with histories of CIN 2+ shouldundergo annual screening <strong>for</strong> 20 yearsafter treatment.•• HPV vaccination does not changeany of <strong>the</strong> <strong>for</strong>egoing recommendations.David Plourd, MDWomen <strong>Exam</strong>
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