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  #1  
Old 08-23-2011
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ObGyn Pap Smear Recommendation and Cervical Cancer Screening

hey Guy was going through the new Internal Med Book...MTB.. it says the guidelines for cervical pap smears have changed.
he USPSTF strongly recommends screening for cervical cancer in women who have been sexually active and have a cervix.
Grade: A Recommendation.
The USPSTF recommends against routinely screening women older than age 65 for cervical cancer if they have had adequate recent screening with normal Pap smears and are not otherwise at high risk for cervical cancer (go to Clinical Considerations).
Grade: D Recommendation.
The USPSTF recommends against routine Pap smear screening in women who havehad a total hysterectomy for benign disease.
Grade: D Recommendation.
The USPSTF concludes that the evidence is insufficient to recommend for or against the routine use of new technologies to screen for cervical cancer.
Grade: I Statement.
The USPSTF concludes that the evidence is insufficient to recommend for or against the routine use of human papillomavirus (HPV) testing as a primary screening test for cervical cancer.
Grade: I recommendation.


Can anyone deduce from this if we have to start at at exactly 21 years or with in 3 years of the onset of sexual activity....
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  #2  
Old 08-23-2011
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its at 21...doesn't say here but that's what they recommend...read it somewhere...
so
no pap after 65
no hpv testing as a screen
no pap post hysterectomy
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Old 08-24-2011
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Quote:
Originally Posted by Kais_MD View Post
Can anyone deduce from this if we have to start at at exactly 21 years or with in 3 years of the onset of sexual activity....
It means that we have to start taking Pap smears after 3 of start of sexual activity.
or if somebody reaches age 21, which ever comes first.
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Old 08-24-2011
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Quote:
Originally Posted by step1an View Post
It means that we have to start taking Pap smears after 3 of start of sexual activity.
or if somebody reaches age 21, which ever comes first.
The optimal age to begin screening is unknown. Data on natural history of HPV infection and the incidence of high-grade lesions and cervical cancer suggest that screening can safely be delayed until 3 years after onset of sexual activity or until age 21, whichever comes first.4 Although there is little value in screening women who have never been sexually active, many U.S. organizations recommend routine screening by age 18 or 21 for all women, based on the generally high prevalence of sexual activity by that age in the U.S. and concerns that clinicians may not always obtain accurate sexual histories.

http://www.uspreventiveservicestaskf...r.htm#clinical
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Old 08-24-2011
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I think controversial issues will not be asked !

It s better to learn the straight things which are the proven facts !

Pap smear :

3 yrs after sexual activity or 21 yrs whichever comes first.

Do an early screening in high risk group.

If anything else plz add but proven facts !
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  #6  
Old 09-11-2011
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Default cervical CA screening

cervical ca screening by pap smear should start at
21 yrs ov age(always)
or
21yrs ov age or 3 yrs after the person becomes sexually active;whichever comes first
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  #7  
Old 09-11-2011
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Patient under 30 years old screening annually if using conventional methods or every 2 years if using liquid based methods. If the patient is ≥ 30 years, screen every 2 to 3 years if ≥ 3 normal annual Pap smears in a row.
At the age of 70 you can stop screening if the patient has ≥ 3 consecutive normal Pap smears.
High risk HPV are: 16, 18 & 30s.
Papillomavirus vaccine is routine for all women between the age of 11 to 26.
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  #8  
Old 09-11-2011
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Quote:
Originally Posted by amberafzal View Post
cervical ca screening by pap smear should start at
21 yrs ov age(always)
or
21yrs ov age or 3 yrs after the person becomes sexually active;whichever comes first
i think USPSTF recommends 21 or 3yrs before becoming sexually active...
but American college of obs n gynae recommends 21 yrs always...!!
http://edition.cnn.com/2009/HEALTH/1...cer/index.html
http://www.uspreventiveservicestaskf.../cervcanrr.htm

i think for exam purpose we should follow obs gynae college...what do u guys say??
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Old 09-11-2011
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Quote:
Originally Posted by ag2011n View Post
Patient under 30 years old screening annually if using conventional methods or every 2 years if using liquid based methods. If the patient is ≥ 30 years, screen every 2 to 3 years if ≥ 3 normal annual Pap smears in a row.
At the age of 70 you can stop screening if the patient has ≥ 3 consecutive normal Pap smears.
High risk HPV are: 16, 18 & 30s.
Papillomavirus vaccine is routine for all women between the age of 11 to 26.
Until age 70 or 65?
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Old 09-12-2011
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Quote:
Originally Posted by dr_mhm View Post
until age 70 or 65?
it s 65 yrs !
Look at the post above USPSTF link !
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Old 09-12-2011
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Quote:
Originally Posted by aasiaafzal View Post
i think USPSTF recommends 21 or 3yrs before becoming sexually active...
but American college of obs n gynae recommends 21 yrs always...!!
http://edition.cnn.com/2009/HEALTH/1...cer/index.html
http://www.uspreventiveservicestaskf.../cervcanrr.htm

i think for exam purpose we should follow obs gynae college...what do u guys say??
i think we should follow USPSTF link !
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  #12  
Old 09-12-2011
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Quote:
Originally Posted by aasiaafzal View Post
i think USPSTF recommends 21 or 3yrs before becoming sexually active...
but American college of obs n gynae recommends 21 yrs always...!!
http://edition.cnn.com/2009/HEALTH/1...cer/index.html
http://www.uspreventiveservicestaskf.../cervcanrr.htm

i think for exam purpose we should follow obs gynae college...what do u guys say??
ya even i will go with 21 yr regardless of onset of sexual activity ,as given in uworld which they have mentioned as a new guideline for starting pap smear.
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  #13  
Old 09-13-2011
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According to kaplan video's lecture is 70 years.
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Old 09-13-2011
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so its 21 to 65 acc to usptf. and for those who have undergone hysterectomy for malignant dis or have undergone ablative procedures fr CIN, routine screening is continued after 3 pap smears have reported to be normal( done every 6 mo after the procedure ). correct me if am wrong
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  #15  
Old 11-16-2011
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I really like this post: (final table w/ recommendation of ACOG, ACS and USPSTF)

http://www.usmle-forums.com/usmle-st...ng-cancer.html
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