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Teenage girls urged to visit gynecologist before Pap testing begins

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Adolescent girls should make their first visit to an obstetrician-gynecologist around 13 to 15 years of age, even though routine Pap testing doesn’t usually start until they’re older, according to a recommendation from the American College of Obstetricians and Gynecologists (ACOG).

Two years ago, the American Cancer Society changed its recommendations for when cervical cancer screening should begin (see Reuters Health report, November 14, 2002). Their guidelines suggest that a first Pap test should be obtained within 3 years after a woman begins having intercourse or no later than 21 years of age.ACOG fears that teenagers and their parents will interpret this to mean that routine gynecologic care is not necessary until then. They have therefore issued a committee opinion, advising physicians to stress that patients should visit an ob/gyn before they become sexually activity, and to inform them of the difference between a Pap test and a routine annual exam. Even if a pelvic examination does not take place at a patient’s first visit, physicians can provide eduction about the need for STD testing when sexual activity begins.The committee also recommends that physicians consider more than just age at first intercourse when considering Pap testing. A history of other STDs, exposure to multiple sexual partners, and the presence of immune deficiency put girls at higher risk of infection with human papillomavirus (HPV), which in turn increases the chances for cervical intraepithelial neoplasia. “Obtaining a complete and accurate sexual history is, therefore, critical,” they warn.The authors also note, however, that cervical lesions may regress spontaneously, and that aggressive management may be harmful to future fertility and cervical competency. Therefore, they add, patients with abnormal Pap test results should be counseled and monitored closely, with therapy reserved for those with high-grade neoplasia. (Source: Obstet Gynecol 2004;104:885-889: Reuters Health News: Oncolink: October 2004.)


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Posted On: 1 October, 2004
Modified On: 3 December, 2013

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