Cervical Cancer Screening

Question 1

What age do you start PAP smears?

Answer 1

21: regardless of sexual activity

Question 2

How often do you get a PAP smear if age <30?

Answer 2

every 3 years with PAP alone

Question 3

How often do you screen in patients age >30?

Answer 3

Pap alone every 3 years or Pap + HPV co-testing every 5 years for as long as they are both negative

Question 4

What types of HPV are associated with cervical cancer?

Answer 4

16 and 18

Question 5

What types of HPC are associated with Condyloma Acuminate (Genital warts)?

Answer 5

6 and 11

Question 6

If screening is positive for high-risk HPV what do you do next?

Answer 6

Colposcopy

Question 7

If pap shows atypical glandular cells what do you do next?

Answer 7

Colposcopy with endometrial sampling

Question 8

If PAP shows atypical endometrial cells what do you do next?

Answer 8

Endometrial and endocervical sampling

Question 9

How do you manage abnormal HPV with (-) Pap in patients aged >30?

Answer 9

HPV DNA typing for 16 and 18 now or repeat co-testing in 1 year

Question 10

What is routine screening for ages 21-25?

Answer 10

Cytology every 3 years

Question 11

If cytology shows Atypical Squamous Cells of Undetermined Significant (ASCUS) in patients aged 21-25 what do you do?

Answer 11

Repeat cytology in 1 year

Question 12

If Cytology shows Low-grade squamous intraepithelial lesion (LSIS) in patients aged 21-25 what do you do next?

Answer 12

repeat cytology in 1 year

Question 13

If Cytology shows High-grade squamous Intraepithelial lesions what do you do next?

Answer 13

Colposcopy and Endocervcial Curretage (ECC) regardless of age

Question 14

What is routine screening for ages 25-30?

Answer 14

Cytology every 3 years

Question 15

If cytology shows Atypical Squamous Cells of Undetermined Significant (ASCUS) in patients aged 25-30 what do you do?

Answer 15

Order HPV
-HPV (+): Colposcopy and ECC
-HPV (-): Repeat pap in 3 years

Question 16

If Cytology shows Low-grade squamous intraepithelial lesion (LSIS) in patients aged 25-30 what do you do next?

Answer 16

Colposcopy and ECC

Question 17

What is routine screening for ages 30-65?

Answer 17

Cytology every 3 years or Cytology + HPV every 5 years or HPV alone every 5 years

Question 18

If cytology shows Atypical Squamous Cells of Undetermined Significant (ASCUS) in patients aged 30-65 what do you do?

Answer 18

Order HPV
-HPV (+): colposcopy and ECC
-HPV (-): repeat pap in 3 years

Question 19

If Cytology shows Low-grade squamous intraepithelial lesion (LSIS) in patients aged 30-65 what do you do next?

Answer 19

Order HPV
-HPV (+): colposcopy and ECC
-HPV (-): Repeat pap in 1 year

Question 20

Who gets the HPV vaccination?

Answer 20

M and F starting at age 11: can get until age 45