Cervical Cancer Screening

Question 1

In a patient with HIV when do you initiate cervical cancer screening?

Answer 1

First pap with 1 year of first intercourse, no later than 21 yrs

Question 2

In a patient with HIV when do you stop screening for cervical cancer?

Answer 2

Continue screening whole life, do not stop at 65yrs

Question 3

With what test AND at what interval do you screen a HIV positive patient who is < 30 yrs old

Answer 3

Pap with cytology q 6 months followed by yearly for 3 tests. can increase to q 3 years if all negative

Question 4

With what test AND at what interval do you screen an HIV positive patient who is > 30 yrs old

Answer 4

Pap with cytology AND cotest for 3 years, if normal cytology and cotest can increase to q 3 years

Question 5

Most HPV infections clear in what interval?

Answer 5

8-24 months

Question 6

What is the most common age group to diagnose cervical cancer?

Answer 6

35- 55 yrs old

Question 7

In general population at what age do you start primary HPV testing and at what interval?

Answer 7

HPV testing starting at 30ys, q 5 years

Question 8

What criteria must be met to stop cervical cancer screening at age 65 yrs?

Answer 8

1. 3 consecutive negative cytology OR 2 consecutive negative cytology with cotest in the last 10 years
2. most recent test within the last 5 years
3. No history of CIN 2 or greater

Question 9

How much time does it take for HPV to progress to Cancer?

Answer 9

10 years

Question 10

What is the management of patient who is > 30yrs, HPV HR other +, Cytology negative?

Answer 10

Repeat Co test in 1 year

Question 11

What is the management of a patient who is > 30 yrs, HPV 16/18 + and cytology negative?

Answer 11

Colposcopy

Question 12

If a pathologists notes Koilocytosis what does that correlate with?

Answer 12

LSIL

Question 13

What percent of dysplasia will resolve spontaneously on an excisional biopsy with positive margins?

Answer 13

67%