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July 2014

Can the New Cervical Cancer Screening and Management Guidelines Be Simplified?

Author Affiliations
  • 1Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts

Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Intern Med. 2014;174(7):1029-1030. doi:10.1001/jamainternmed.2014.576

Effective cervical cancer prevention relies on frequent screening and appropriate management of abnormal test results to prevent cells with precancerous changes from progressing to cancer. Historically, guidelines were simple and clear: screen annually with Papanicolaou (Pap) tests, evaluate abnormal results with colposcopy and diagnostic biopsy, treat most abnormal results by means of either excision (loop excision) or ablation (cryosurgery), and then resume annual Pap testing. This approach was simple and easy to implement, but it led to overevaluation and overtreatment of many women still in their childbearing years.

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