Cervical Cytology

Question 0

Most HPV infection is transient and poses little risk of progression. Few infections persist, but persistence at 1 year and 2 years strongly predicts subsequent risk of high-grade cervical intraepithelial neoplasia 3 (CIN 3+) regardless of age. Which hpv strains are high risk?

Answer 0

16 18

Question 1

Human papillomavirus 16 has the highest carcinogenic potential and accounts for approximately

Answer 1

55-60% of all cervical cancer worldwide

Question 2

Risk factors known to increase the likelihood of persistence

Answer 2

cigarette smoking, a compromised immune system, and human immunodeficiency (HIV) infection (13, 14).

Question 3

Most young women, especially those younger than 21 years, have an effective immune response that clears the infection in an average of …..or reduces the viral load in ….of women to undetectable levels in an average of 8–24 months

Answer 3

8 months or 80-90%

Question 4

Progression from persistent infection to cancer is slow, and the time course from CIN 3 to invasive cancer averages between

Answer 4

8.1 years and 12.6 years

Question 5

A low-grade squamous intraepithelial lesion (LSIL) cytology test result is generally associated with transient HPV infection t or false

Answer 5

True

Question 6

Endocervical sampling may be conducted either by traditional ECC with a ___ with vigorous ____or both.

Answer 6

Sharp currette or vigorous endocervical brushing or both

Question 7

In general, endocervical sampling should be considered in the following circumstances

Answer 7

1. ASC-US or LSIL cervical cytology
2. In women with atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesions (ASC-H), HSIL, atypical glandular cells (AGC), or AIS cytology test results, endocervical sampling should be considered as part of the initial colposcopic evaluation (61) unless excision is planned. If an excision is planned, endocervical sampling may be omitted (62), although it may be performed at the time of the procedure after the excision to assess the completeness of the procedure.

Question 8

These revised screening guidelines extended the screening interval to ____using cytology testing alone in women younger than 30 years.

Answer 8

3 yrs

Question 9

For women aged 30–65 years, the interval was extended to every ____after negative cytology test results alone or ____following negative results from cytology and HPV co-testing.

Answer 9

3 yrs or 5 years

Question 10

How should women with unsatisfactory cytology test results be managed?

Answer 10

For women with unsatisfactory cytology test results and no, unknown, or a negative HPV test result, repeat cytology testing in 2–4 months is recommended. Triage using reflex HPV testing is not recommended. Treatment to resolve atrophy or obscuring inflammation when a specific infection is present is acceptable. In women aged 30 years and older with a positive HPV co-test result, repeat cytology testing in 2–4 months or colposcopy is acceptable. Colposcopy is recommended for women with two consecutive unsatisfactory cytology test results (3).

An unsatisfactory cervical cytology test result is, by definition, unreliable for detecting epithelial abnormalities.

Question 11

What is the appropriate follow-up for women aged 30 years and older with normal cervical cytology screening test results and positive HPV co-test results?

Answer 11

For women 30 years of age and older with HPV-positive but cytology-negative co-testing results, repeat co-testing at 1 year is acceptable. At the 1-year repeat co-test, if the HPV test result is positive or cytology is ASC-US or worse, colposcopy is recommended. If the 1-year repeat co-test result is HPV-negative and cytology negative, repeat co-testing in 3 years is recommended.