I know this isn’t about pregnancy, but every now and then I feel the need to comment on noteworthy news for the vast majority of women who are not pregnant…

This month, the American College of Obstetricians and Gynecologists released a Committee Opinion on the Evaluation and Management of Abnormal Cervical Cytology and Histology in the Adolescent. In plain English, that means that there are new guidelines about how to deal with abnormal Pap smears and cervix biopsies in young women.

The new guidelines have come about because of improved understanding of the natural history and cancer-causing potential of human papilloma virus (HPV), and because we have improved Pap smears (liquid-based) and high-risk HPV DNA testing available to us now. The net result is that we are finally able to say that most HPV-related problems in young women are unlikely to cause cancer, and we are comfortable using the new tools to follow the abnormalities conservatively rather than treat them aggressively unnecessarily.

This is good news, because most HPV infections and their resulting abnormalities will resolve on their own without treatment. The treatments (cryotherapy, laser, and LEEP) are known to increase the risk of damage to the cervix, and it seems prudent to limit these procedures in the relatively young.

The bottom line here is that if you or your young daughter’s Pap smear is abnormal, it is now reasonable to take a more conservative approach to managing these lesions without a fear of cancer developing. Such observation requires good compliance with follow-up, however, and only well-informed, reliable young women should take advantage of these relaxed guidelines.

RW, MD

Related Topics: WebMD Video: Cervical Cancer Vaccine, New Guidelines for Cancer Screening

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