April 2019

The Guideline Guys - Cervical Cancer Screening

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David S. -

Hey guys. Maybe I missed this, but does cytology find any different causes of cervical cancer versus just HPV-associated cervical cancer? I understand that the HPV appears more sensitive, but would we miss certain cases of cervical cancer by only screening with HPV testing? Thanks!

Heidi J., MD -

Hi - This is a really great question, thank-you! HPV causes the vast majority of cervical cancers (91% as pre the CDC link below), but you are correct, cytology AND physical exam, will occasionally pick up a malignancy or other concerning diagnosis that are not HPV related.

Here's a 2003 article from the Guideline Guys editors which shows that HPV caused all CIN-3 and cervical CAs in a group of 511 women: https://www.ncbi.nlm.nih.gov/pubmed/12861148

Here's the CDC data: https://www.cdc.gov/cancer/hpv/statistics/cases.htm

We'll be sure to update this topic as new data becomes available.

thomas k. -

I am getting back into Family Medicine (from the ER) and I would like to screen using HPV testing every 5 years.

Question - is the HPV testing still from cervical swab or a blood serum testing?

Sorry for being out of the loop

Heidi J., MD -

Good question! It's cervical swab. Here' s a neat article that discusses the benefits of self-swabs. Hope the transition back to FM is going well :)

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