The Law of Unintended Consequences

Has the guidelines that encourage less Pap testing over the course of a woman’s life contributed to less women being screened for STDs such as Chlamydia? According to a study published this week, yes.  The cohort is rather small–3000 teenagers and young women–but even so, the results are striking. Before 2009, 30 percent of patients were screened for Chlamydia; after 2009, only 1 percent were.

While this is discouraging, the CDC found that teenagers are having less sex than they were twenty-five years ago, which some attribute to the HPV vaccine and its accompanying education.

Further reading on the relationship between HPV vaccines, Pap screening, and STD testing:

Chicago Tribune

NPR

Healthday

Swails

Kelly Swails, MT(ASCP), is a laboratory professional, recovering microbiologist, and web editor for Lab Medicine.

Next Steps in Cytotechnology

ASCP and ASC have put together a program to enable cytotechnologists to grow their skills and advance their careers. During this workshop, attendees will learn how to engage as a part of the clinical team and broaden their skill set to include fluorescent in-situ hybridization and interpretation of applied molecular tests.

AJCP_ACE

If you’d like to attend this program, you can register before April 30 to get a discount.

Viral DNA Testing, Cervical Cancer, and Cytology

An FDA panel recently recommended use of Roche’s Cobas HPV DNA test as the initial screening tool for cervical cancer instead of the ubiquitous Pap smear. The panel found that “A negative HPV result predicted a lower 3-year risk of ≥CIN3 than did a negative cytology result, suggesting that using HPV as the primary test is superior to cytology for cervical cancer screening.The low 3-year CIR for a negative HPV result also confirmed the safety of a 3-year interval for HPV primary screening and officer clinicians more confiedence in a negative HPV result than a negative cytology result.”

While this isn’t a final FDA guideline, it’s conceivable that clinicians could alter their practice based on these findings. Of course, this will affect the cytology and molecular diagnostics departments, as well. What do you think? Is HPV viral testing the way to go? Or should we stick with the test that’s been around for decades?