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Berman - Figure 12 - Screening & Triage by HPV DNA Testing

Screening and triage by HPV testing. 

  • To recap, if both Pap and HPV DNA tests are negative, we can repeat co-testing in 5 years - regardless of sexual history.  

  • Even if my patient has a new partner or many new partners and potentially has been infected by HPV.  Even if she had a Pap-negative/HPV-negative test today, and she has a new partner tomorrow, there is no need to rescreen her for 5 years, because most infections clear in 8-9 months in women of all ages.  

  • In 24 months, the majority of infections have cleared, and even if pre cancer develops, we do not see progression to invasive disease in a short period of time.  

  • So, sexual history is not a factor in when women are rescreened, and if HPV is negative after co testing, it is safe then to wait 5 years.

  • Finally, there is no need to resume screening in women over age 65 even if they become sexually active.  

Complete references for all slides

References

[95] Ho GYF, Bierman R, Beardsley L, Natural history of cervicovaginal papillomavirus infection in young women. N Engl J Med. 1998;338:423-8

[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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