Human papillomavirus testing for precancerous lesions of the cervix.
As new technologies are introduced that increase the sensitivity of detecting patients at risk and the incidence of cervical cancer continues to decrease in the US, annual screening for this disease may actually be overscreening. It has been shown that the screening interval can safely be increased to every 2 years if liquid-based testing is performed with reflex HPV testing in patients under 30 and can be increased to every three years in patients over the age of 30 if they are done together and both are negative.13,14 As we move into the age of risk stratification as a screening tool with HPV testing and liquid-based screening, it is imperative that the aforementioned recommendations are followed in order to keep the costs of screening at a minimum. Unfortunately, despite data confirming its safety and efficacy, many patients are unconvinced. The overwhelming respondents in one series would still seek to obtain annual screening. In order to complete the paradigm shift in the screening for cervical cancer using the current technologies, more education will be required of the public and health care community to understand and accept the differences, most notably the increased screening interval. The true effects of the HPV vaccine will not be known for some time. Therefore, appropriate screening is still imperative even for those vaccinated because it does not offer complete protection from other strains of the HPV virus.
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