hot topics clinical medicine acha annual meeting boston, ma may 31, 2013
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Hot TopicsClinical Medicine
ACHA Annual Meeting
Boston, MA
May 31, 2013
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Important publication-LAST
Consensus Guidelines (2012) The Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions: Background and Consensus Recommendations From the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology
Journal of Lower Genital Tract Disease, July 2012
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Basic intervals, normal pap history
Don’t start paps until 21 21-29 every 3 years, no co-testing 30-64 every 3 years or every 5 years with co-testing Over 65 no testing
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Unsatisfactory cytology on pap
With liquid-based technology, most reasons for unsatisfactory cytology are eliminated EXCEPT inadequate cells
Don’t use negative HPV co-testing as a reason not to repeat
Repeat test in 2-4 months
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Absent EC/TZ
Prior recommendation was early repeat
Under 30, manage as normal
Over 30, co-test or manage as normal If negative co-test,
routine repeat If positive co-test,
repeat cyto+co-test 1 year or
Genotype for 16, 18
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New concept
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16, 18?
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Test Name Result Flag(s) Reference Range Reported Date Footnote CLINICAL INFORMATION: SEE NOTE ALL NL PAPS LMP: 4/6/2013 PREV. PAP: N/A PREV. BX: N/A SOURCE: Cervix STATEMENT OF ADEQUACY: SEE NOTE Satisfactory for evaluation. Endocervical/transformation zone component present. INTERPRETATION/RESULT: SEE NOTE Negative for intraepithelial lesion or malignancy. INFECTION: SEE NOTE Shift in vaginal flora suggestive of bacterial vaginosis. COMMENT: SEE NOTE This Pap test has been evaluated with computer assisted technology. CYTOTECHNOLOGIST: SEE NOTE CXP, CT(ASCP) HPV DNA (HIGH RISK) DETECTED A (NOT DETECTED) High-risk HPV types 16,18,31,33,35,39,45,51,52,56,58,59, or 68 may cause cervical cancer or itsprecursors.The analytical
performance characteristics of thisassay, when used to test SurePath or vaginal specimens,have been determined by Quest Diagnostics.Methodology: Hybrid Capture with Signal Amplification.
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New concept
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