Cervical Cancer. This post will cover the points you need to know for your board exams as well as for teaching residents on the daily rounds. Please don't use the information here to treat your patients.
Prevention of Cervical Cancer
HPV vaccination routinely recommended at age 11–12 years (can start at age 9 years) and catch-up HPV vaccination recommended for all persons through age 18 years if not adequately vaccinated
2- or 3-dose series depending on age at initial vaccination:
Age 9 –14 years at initial vaccination: 2-dose series at 0 and 6–12 months (minimum interval: 5 months; repeat dose if administered too soon)
Age 15 years or older at initial vaccination: 3-dose series at 0, 1–2 months and 6 months (minimum intervals: dose 1 to dose 2: 4 weeks / dose 2 to dose 3: 12 weeks / dose 1 to dose 3: 5 months; repeat dose if administered too soon)
Screening for Cervical Cancer
As per 2023, USPSTF recommends starting with cervical cancer screening at age of 21with Pap smear every 3 years through age of 29.
After the age of 29 until 65 one of these 3 options: Pap test alone every 3 years, HPV test alone every 5 years, or Pap test and HPV test every 5 years.
Patients who had hysterectomy with the cervix removed due to cancer or CIN grade 2 or 3 need to continue screening (preferably for 20 years after surgery).
Risk factors that indicate more frequent or close follow up include HIV infection, immunocompromised people, in utero exposure to diethylstilbestrol, and previous cervical cancer or CIN grade 2 or 3.
For further reading about the topic you may check Clinical Gynecologic Oncology.
The information in this post is not for patients and shouldn't be used in treating patients. Please refer to your doctor for medical advice.