American College of Obstetrics and Gynecology
Mark Schiffman, MD, MPH, and Nicolas Wentzensen, MD, PhD
Cervical cancer is one of the most common female malignancies worldwide; 80% of cases occur in low-resource regions.1,2 Screening programs have been very successful in the United States, Europe, and other regions able to achieve broad and sustained coverage. In the United States, the disease is controlled at an annual cost of billions of dollars representing a major commitment by patients and clinicians. In fact, cervical cancer screening and management of minor screening abnormalities are among the most time-consuming parts of some gynecology practices.
Cervical cancer prevention can now be made even better. Substantial modifications of practice are forthcoming, motivated by improved understanding of human papillomavirus (HPV) natural history and cervical
carcinogenesis. In this update, we will summarize the new knowledge and its possible implications in the United States.
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