Patient Care Hematology & Oncology - October 2007 - (Page 20)

I Cervical cancer guidelines Express Stop Women are becoming more knowledgeable about the link between HPV and cervical cancer and its role in abnormal cervical cytology. women. In addition, due to our mobile society and to the ever-changing third-party payer landscape, clinicians often do not have a long enough record on many of their patients to reliably determine whether at least 3 prior consecutive normal Pap results have been obtained. These factors are likely to continue to challenge the goal of safely decreasing the number of cervical screens in a woman’s lifetime when screening is based on cytology alone. history of how HPV-induced cervical precancer develops and the usual amount of time required to progress to invasive cancer. Embracing any major departure from status quo practice patterns is always a challenge until the new recommendations become routine and segue into the established practice. Until recently, most of the public had never heard of HPV or only associated it with genital warts. But this, too, is changing, and women are becoming more knowledgeable about the link between HPV and cervical cancer and its role in abnormal cervical cytology. A patient’s even limited awareness of the culprit can set the stage for the clinician to open up much-needed communication on appropriate recommended cervical screening options and how they relate to HPV, the cause of the abnormal cervical cellular changes for which the patient is being screened. I Conclusions Primary cervical screening guidelines have changed dramatically within the past 3 years. Most of the changes reflect a better understanding of the natural REFERENCES 1. Saslow D, Runowicz CD, Solomon D, et al. American Cancer Society guideline for the early detection of cervical neoplasia and cancer. CA Cancer J Clin. 2002;52:342-362. 2. American College of Obstetricians and Gynecologists. Cervical cytology Screening. ACOG Practice Bulletin. Number 45. Washington, DC; August 2003. 3. Fink DJ. Change in American Cancer Society Checkup Guidelines for detection of cervical cancer. CA Cancer J Clin. 1988;38:127-128. 4. American College of Obstetricians and Gynecologists. Human Papillomavirus. ACOG Practice Bulletin, Number 61. Washington, DC; April 2005. 5. Wright TC Jr, Schiffman M, Solomon D, et al. Interim guidance for the use of human papillomavirus DNA testing as an adjunct to cervical cytology for screening. Obstet Gynecol. 2004;103:304-309. 6. National Cancer Institute. Cancer of the cervix uteri. http://seer.cancer. gov/statfacts/html/cervix.html. Accessed October 1, 2007. 7. Woodman CB, Collins S, Winter H, et al. Natural history of cervical human papillomavirus infection in young women: a longitudinal cohort study. Lancet. 2001;357:1831-1836. 8. Ho GY, Bierman R, Beardsley L, et al. Natural history of cervicovaginal papillomavirus infection in young women. N Engl J Med. 1998;338: 423-428. 9. Winer RL, Lee SK, Hughes JP, et al. Genital human papillomavirus infection: incidence and risk factors in a cohort of female university students. Am J Epidemiol. 2003;157:218-226. 10. Moscicki AB, Hills N, Shiboski S, et al. Risks for incident human papillomavirus infection and low-grade squamous intraepithelial lesion development in young females. JAMA. 2001;285:2995-3002. 11. Baseman JG, Koutsky LA. The epidemiology of human papillomavirus infections. J Clin Virol. 2005;32(suppl 1):S16-S24. Dr Cox discloses that he is member of the speakers’ bureau for Digene, manufacturer of Hybrid Culture 2, and a consultant for Gen-Probe. 12. Moscicki AB, Shiboski S, Broering J, et al. The natural history of human papillomavirus infection as measured by repeated DNA testing in adolescent and young women. J Pediatr. 1998;132:277-284. 13. Anhang R, Goodman A, Goldie SJ. HPV communication: review of existing research and recommendations for patient education. CA Cancer J Clin. 2004;54:248-259. 14. Danilevicius Z. The Walton report. JAMA. 1976;236:2098-2099. 15. USPHS/IDSA guidelines for the prevention of opportunistic infections in persons infected with human immunodeficiency virus: a summary. MMWR Recomm Rep. 1995;44(RR-8):1-34. 16. Frame PS, Frame JS. Determinants of cancer screening frequency: the example of screening for cervical cancer. J Am Board Fam Pract. 1998;11:87-95. 17. Cuzick J. American Cancer Society Cervical Screening Guidelines Committee Meeting; April 2002. 18. Parazzini F, Negri E, La Vecchia C, et al. Screening practices and invasive cervical cancer risk in different age strata. Gynecol Oncol. 1990;38:76-80. 19. Sawaya GF, Sung HY, Kinney W, et al. Cervical cancer after multiple negative cytologic tests in long-term members of a prepaid health plan. Acta Cytol. 2005;49:391-397. 20. Viikki M, Pukkala E, Hakama M. Risk of cervical cancer after a negative Pap smear. J Med Screen. 1999;6:103-107. www.patientcareonline.com Visit our Web site for ® Click-through links to the Internet resources listed in these pages 20 PATIENT CARE HEMATOLOGY & ONCOLOGY www.patientcareonline.com http://seer.cancer.gov/statfacts/html/cervix.html http://seer.cancer.gov/statfacts/html/cervix.html http://www.patientcareonline.com http://www.patientcareonline.com

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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

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