Patient Care Hematology & Oncology - October 2007 - (Page 15) How to integrate the new cervical cancer guidelines into practice IMAGE: JIM SHIVE An expert helps clinicians make sense of the screening intervals in the new guidelines for cervical cancer. I CONTRIBUTOR J. THOMAS COX, MD, Director, Gynecology and Colposcopy Clinic, University of California-Santa Barbara, Santa Barbara, Calif. Dr Cox is President-elect, American Society for Colposcopy and Cervical Pathology. t has been roughly 5 years since the American Cancer Society (ACS) and the American College of Obstetricians and Gynecologists (ACOG) issued new primary cervical screening guidelines.1,2 So why are so many clinicians still struggling with how best to integrate them into their practices? The answer lies in how radically several guidelines depart from the status quo. Clinicians and the public alike have become accustomed to—and maybe too comfortable with—the standard practice that became entrenched after cervical screening guidelines were introduced in the late 1970s and updated in 1988.3 Long tradition and familiarity with these established guidelines for a quarter of a century have made rapid acceptance of new approaches to screening all the more challenging. Further impetus to moving past business-as-usual screening patterns has come from the 2004 “Interim Guidance on the use of HPV testing in primary screening” and the 2005 ACOG Practice Bulletin Number 61.4,5 Although all these recommendations may seem like information overload, it is imperative for clinicians to understand the rationale behind each guideline and how to apply each to routine patient management. The new guidelines advise when to begin screening, the differing screening intervals once you do begin, and when to cease screening. My goal in this article is to review the changes in screening intervals—addressing when and how often to screen and the rationale behind the changes—and to illustrate them OCTOBER 2007 PATIENT CARE HEMATOLOGY & ONCOLOGY 15
Table of Contents Feed for the Digital Edition of Patient Care Hematology & Oncology - October 2007 Patient Care - Hematology & Oncology - October 2007 Research Digest Contents Information for Authors Medicine in the News Strategies for Bridge Anticoagulation Therapy How to Integrate the New Cervical Cancer Guidelines into Practice Dermatology Case Challenge Clinical Clips Classified Advertising Patient Care Hematology & Oncology - October 2007 Patient Care Hematology & Oncology - October 2007 - Patient Care - Hematology & Oncology - October 2007 (Page Cover1) Patient Care Hematology & Oncology - October 2007 - Patient Care - Hematology & Oncology - October 2007 (Page Cover2) Patient Care Hematology & Oncology - October 2007 - Research Digest (Page 1) Patient Care Hematology & Oncology - October 2007 - Research Digest (Page 2) Patient Care Hematology & Oncology - October 2007 - Contents (Page 3) Patient Care Hematology & Oncology - October 2007 - Information for Authors (Page 4) Patient Care Hematology & Oncology - October 2007 - Medicine in the News (Page 5) Patient Care Hematology & Oncology - October 2007 - Medicine in the News (Page 6) Patient Care Hematology & Oncology - October 2007 - Strategies for Bridge Anticoagulation Therapy (Page 7) Patient Care Hematology & Oncology - October 2007 - Strategies for Bridge Anticoagulation Therapy (Page 8) Patient Care Hematology & Oncology - October 2007 - Strategies for Bridge Anticoagulation Therapy (Page 9) Patient Care Hematology & Oncology - October 2007 - Strategies for Bridge Anticoagulation Therapy (Page 10) Patient Care Hematology & Oncology - October 2007 - Strategies for Bridge Anticoagulation Therapy (Page 11) Patient Care Hematology & Oncology - October 2007 - Strategies for Bridge Anticoagulation Therapy (Page 12) Patient Care Hematology & Oncology - October 2007 - Strategies for Bridge Anticoagulation Therapy (Page 13) Patient Care Hematology & Oncology - October 2007 - Strategies for Bridge Anticoagulation Therapy (Page 14) Patient Care Hematology & Oncology - October 2007 - How to Integrate the New Cervical Cancer Guidelines into Practice (Page 15) Patient Care Hematology & Oncology - October 2007 - How to Integrate the New Cervical Cancer Guidelines into Practice (Page 16) Patient Care Hematology & Oncology - October 2007 - How to Integrate the New Cervical Cancer Guidelines into Practice (Page 17) Patient Care Hematology & Oncology - October 2007 - How to Integrate the New Cervical Cancer Guidelines into Practice (Page 18) Patient Care Hematology & Oncology - October 2007 - How to Integrate the New Cervical Cancer Guidelines into Practice (Page 19) Patient Care Hematology & Oncology - October 2007 - How to Integrate the New Cervical Cancer Guidelines into Practice (Page 20) Patient Care Hematology & Oncology - October 2007 - How to Integrate the New Cervical Cancer Guidelines into Practice (Page 21) Patient Care Hematology & Oncology - October 2007 - How to Integrate the New Cervical Cancer Guidelines into Practice (Page 22) Patient Care Hematology & Oncology - October 2007 - Dermatology Case Challenge (Page 23) Patient Care Hematology & Oncology - October 2007 - Dermatology Case Challenge (Page 24) Patient Care Hematology & Oncology - October 2007 - Dermatology Case Challenge (Page 25) Patient Care Hematology & Oncology - October 2007 - Clinical Clips (Page 26) Patient Care Hematology & Oncology - October 2007 - Clinical Clips (Page 27) Patient Care Hematology & Oncology - October 2007 - Classified Advertising (Page 28) Patient Care Hematology & Oncology - October 2007 - Classified Advertising (Page Cover3) Patient Care Hematology & Oncology - October 2007 - Classified Advertising (Page Cover4)
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