vradojc1
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Age to start?
1st sex + 3 years (at latest) - I'm fine with that
and
21 years of age?
or
18 years of age?
In the literature I'm finding both, so which one to pick?
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| Justice
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UW says that all sexually active women (no mater what age, probably after first intercourse that never happens) have to have PAP smear tests annually for thee consecutive years, and if those were negative then you switch to a test done every third year.
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| vradojc1
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That is clear, but the q is about sexually "inactive". When to start 18, or 21?
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| coolmavs
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If I remember correctly it is 18.......
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| vradojc1
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Here is UpToDate:
Cervical cancer screening should be started approximately three years after the onset of sexual activity, but no later than age 21. The basis of this recommendation is that high grade cervical intraepithelial lesions (HSIL) are almost entirely related to acquisition of human papillomavirus (HPV) infection through genital skin to skin contact and these lesions usually do not occur until three to five years after exposure to HPV [3]. HSIL is a precursor to cervical cancer. Many adolescent girls and their mothers may be confused by the difference between a pelvic examination, routine gynecologic care, and cervical cancer screening [4]. ACOG suggests that adolescents have their first visit to an obstetrician/gynecologist for assessment of sexual activity, screening, and preventive services before the onset of sexual activity, between ages 13 and 15 years. This visit does not necessarily require a pelvic examination, but should include a sexual history. Cervical cancer screening can then be initiated as previously described."
USPSTF says 21 as well.
Although Kaplan says 18 (I think)
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| jehanzebali
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Kaplan notes 2005-6 clearly mention the NEW screening age in nullipara for cervical Ca as 21 years. The reason being .. majority of the cervical Ca are HPV induced (sexually transmitted )and are squamous but a small percentage can be Adeno Ca ( which is NOT HPV induced ) therefore the screen in nullipara. The latter point has been mentioned in the DVDs.
Screening age of 18 in nullipara is an OLD recommendation mentioned in the kaplan notes BEFORE 2005-6.
i hope this clearifies the point.
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| vradojc1
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I just checked - Kaplan states 21 as well. (2005-2006)
Sorry for bothering. So many books...
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| coolmavs
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Jehanzebali, you are right. Just confirmed that BluePrints the last edition and the kaplan lectures have it at 18 yrs but the new Kaplan 2005-06 clearly states 21 yrs. Maybe they have changed the screening criteria.
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| jehanzebali
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