Why I Vaccinate: Maria Trent, MD, MPH, Associate Professor in Pediatrics at Johns Hopkins Bloomberg School of Public Health, advocates for creating an “HPV-free zone” through vaccination. Dr. Trent speaks to fellow healthcare providers about the importance of vaccinating adolescents against human papillomavirus (HPV).
Cervical Cancer Screening Guidelines
In 2012 updated cervical cancer screening guidelines were issued by the both the USPSTF and the Cervical Cancer Guideline Committee of the ACS-ASCCP-ASCP. The two sets of guidelines were developed separately but are in agreement in most respects. Major changes include delaying the onset of cervical cancer screening to age 21 regardless of sexual history and lengthening of screening intervals to 3-5 years. A summary of both guidelines is below:14,15
- Cervical cancer screening should begin at age 21.
- Most HPV infections acquired in teens and young adults clear up spontaneously, including those caused by high-risk types. It is now recognized that screening young women soon after onset of sexual activity results in large numbers of HPV infections and Pap test abnormalities that can safely be ignored, but that historically have resulted in unnecessary treatment accompanied by preventable anxiety and stress.
- For women ages 20-29, screening with cytology alone every three years
- For women 30 and over:
Screening every five years with cytology/HPV testing (ACS guidelines say “co-testing” is the preferred approach)
Screening every three years with cytology alone
- Some concern over length of intervals, especially five year. However, the superior sensitivity of co-testing in the detecting high-grade diseases also allows for significant extension of cervical cancer screening intervals in women 30 and older.
- For women 65 and over: Cervical cancer screening can end for most women at age 65, provided they have a history of adequate screening tests with normal results
- Post-hysterectomy: Screening is not recommended for women of any age after removal of the cervix unless there is a history of significant cervical precancer (CIN2 or higher).
The HPV Toolkit offers providers an overview of HPV and cervical cancer screening, HPV vaccine recommendations, genital warts, and HPV-related cancers. It also offers suggested counseling messages for patients.
Continuing Medical Education:
ASHA, in collaboration with Primary Care Education, developed a program to educate primary care physicians on HPV-related disease in both male and female patients as well as HPV vaccine efficacy and its best use in patients. Click here to download a copy of “Understanding Anogenital HPV: Infections, Diseases and Vaccines in Male and Female Patients.”
HPV-related Diseases: Separating Fact from Fiction
This activity, done in collaboration with Medscape Education Pediatrics, looks at HPV infections and diseases in males and covers new data in this area. Click here to access this video presentation.
FAQs on HPV for clinicians:
Dr. H. Hunter Handsfield, a clinical professor of medicine at the University of Washington and a leader in STD prevention and research for more than 30 years, answers common questions about HPV in a two-part video series.
Counseling patients on HPV:
A video primer for clinicians on effective patient counseling for HPV and genital warts. The brief video includes talking points on relationships, incidence and prevalence, vaccines, and HPV’s natural history.