HPV screening in teens not cost effective.(Gynecology)

NEW YORK -- Screening for the human papillomavirus in adolescent females is not cost effective because of the high rate of infection in that population, Dr. Edyta C. Pirog said at a gynecology conference sponsored by Mount Sinai School of Medicine.

Since the majority of low-grade squamous intraepithelial lesions will regress spontaneously in adolescent females, most treatment guidelines allow for the observation of these lesions through repeated cytology, said Dr. Pirog, of Weill Cornell Medical College, New York. However, immunosuppressed adolescents, who have a high rate of progression to high-grade squamous intraepithelial lesions, require careful follow-up by physicians, Dr. Pirog said.

The American College of Obstetricians and Gynecologists recently released a new committee opinion advising physicians to take a less aggressive approach to treating abnormal pap test results and benign lesions in adolescents, compared with the approach used in adults (Obstet. Gynecol. 2006;107:963-8). ACOG recommends a noninvasive approach because of the potential risk of cervical incompetence after surgical excision. Adolescent patients who follow their physician's instructions can be treated effectively through follow-up cytology screening at either two 6-month follow-ups or one 12-month follow-up in most cases, according to ACOG. There is a high prevalence of HPV ...