Cervial CA screening Flashcards
In asymptomatic, immunocompetent women, cervical cancer screening with Pap smear starts at age __ , regardless of___
21
sexual activity
Note: this’s same for Ontario. Only exception: delay this test if still virgin at 21y.
In women younger than 30 years old, screening with Pap alone is done every _years
3
After age 30, either do
Pap smear alone every _ years or do Pap smear with HPV co-testing every __ years for as long as both tests are negative.
3
5
HPV types and associations
- Cervical cancer: ___
- Condyloma acuminata__
16 and 18
(genital warts): 6 and 11
If risk of HPV is high, do__
colposcopy.
There are 2 options for managing abnormal HPV with negative Pap in
patients older than 30 years:
Do HPV DNA typing for 16 and 18 now
Repeat co-testing in 1 year
what is the Routine
screening for ages 21-25?
Cytology every 3 years
what is the Routine
screening for ages 25-30?
Cytology every 3 years
what is the Routine
screening for ages 30-65?
Cytology every 3 years OR Cytology and HPV testing every 5 years OR HPV testing alone every 5 years
What to do if cytology result is ASCUS = atypical squamous cells of undetermined? Age 21-25
Repeat cytology in 1 year
What to do if cytology result is ASCUS = atypical squamous cells of undetermined significance? ages 25-65
Order HPV:
HPV+, colposcopy and ECC
HPV–, repeat Pap in 3 years
ECC = endocervical curettage
What to do if cytology result is LSIL = low-grade squamous intraepithelial lesion? ages 21-25
Repeat cytology in 1 year
What to do if cytology result is LSIL = low-grade squamous intraepithelial lesion? age 25-30
Colposcopy and ECC
What to do if cytology result is LSIL = low-grade squamous intraepithelial lesion? 30-65years
Order HPV:
HPV+, colposcopy and ECC
HPV–, repeat Pap in 1 year
What to do if cytology result is HSIL = high-grade squamous intraepithelial lesion?
Colposcopy and ECC required regardless of age
