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Screening
Images
of
HPV
infections
Natural hx of HPV infections
• Most are transient and do not increase a
woman’s risk for cervical cancer.
Behavior of HPV 16
during 30 months of
follow-up (800
infections)
HPV 16
HPV 18
2. HPV test.
Kaiser Study
N=331,818 women > 30
years in prospective co-
testing study
3 screening strategies.
Primary Pap testing every 3 years
Primary HPV testing every 3 years.
Primary cotesting every 5 years.
Age 30-65. Testing with cytology alone every 3 years or co-testing with
cytology and testing for high-risk HPV types every 5 years.
Co-testing “preferred” and cytology “acceptable” by all but USPSTF
Recommendations NOT intended for women with HIV, immunocompromise,
or in utero DES exposure
HPV vaccination.
HPV vaccination
Decreased
Decreased prevalence
prevalence of HPV
of HPV 16 and
16 and 18. 18
Multiple rounds of cotesting.
Multiple rounds of cotesting
16 18 C
Colposcopy
Start at age 25
Colposcopy
Huh WK, et al, Use of primary high-risk human papillomavirus testing for cervical cancer screening:
Interim clinical guidance, Gynecol Oncol (2015), http://dx.doi.org/10.1016/j.ygyno.2014.12.022
Cost Estimate by Screening Strategy
Thanks all !