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Berman - Figure 11 - Telling Pts. About Less Frequent Screening

What do I tell patients about less frequent screening?  We do not want to catch all the changes that will go away on their own.  We will do less harm by doing fewer Pap tests, fewer colposcopies.  HPV testing is so accurate, and I tell my patients, “When you are Pap-negative and HPV-negative you have virtually no risk of disease on your cervix for many years.  And we may safely wait to rescreen you, which is now five years.”

So, it is essentially the best of both worlds when we do two tests (co-testing).  We can find those women who need careful followup because the presence of HPV is a significant risk factor for disease to develop, or for detecting disease that may have been missed in the past.  We may very, very safely wait 5 years until the next screen if both tests are negative.  

Complete references for all slides

References

[94] Saslow D, Solomon D, et al “American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology Screening Guidelines for the Prevention and Early Detection of Cervical Cancer, Journal of Lower Genital Tract Disease, 2012;6;(3):175-204.

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