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Self-Assessment Questions

Obstetrics & Gynecology


Answer 1
  1. Age 21 years or 3 years after initiation of sexual contact. ACOG currently recommends beginning cervical cancer screening approximately 3 years after initiation of sexual intercourse but no later than age 21 years.1 Over 50% of women will be infected with HPV within 4 years after onset of sexual activity.2 In a large cohort study of over 600 female college students, the cumulative incidence of new HPV infection was 43%.2 The 2-year clearance rate of HPV was over 90% however, only 5% of women developed cytologic abnormalities.2 Despite a high prevalence of HPV in sexually active females, only 5% to 15% will develop cervical dysplasia.3

    REFERENCES
    1. ACOG Committee on Practice Bulletins. ACOG Practice Bulletin: clinical management guidelines for obstetrician-gynecologists. Number 45, August 2003. Cervical cytology screening (replaces committee opinion 152, March 1995). Obstet Gynecol 2003;102:417–27.

    2. Ho GY, Bierman R, Beardsley L, et al. Natural history of cervicovaginal papillomavirus infection in young women. N Engl J Med 1998;338:423–8.

    3. Smith JS, Lindsay L, Hoots B, et al. Human papillomavirus type distribution in invasive cervical cancer and high-grade cervical lesions: a meta-analysis update. Int J Cancer 2007;121:621–32.

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