A Common Clinical Dilemma: Management of Abnormal Vaginal Cytology and Human Papillomavirus Test Results

Journal of Lower Genital Tract Disease
Michelle J KhanWarner K Huh

Abstract

Vaginal cancer is an uncommon cancer of the lower genital tract, and standardized screening is not recommended. Risk factors for vaginal cancer include a history of other lower genital tract neoplasia or cancer, smoking, immunosuppression, and exposure to diethylstilbestrol in utero. Although cervical cancer screening after total hysterectomy for benign disease is not recommended, many women inappropriately undergo vaginal cytology and/or human papillomavirus (HPV) tests, and clinicians are faced with managing their abnormal results. Our objectives were to review the literature on vaginal cytology and high-risk HPV (hrHPV) testing and to develop guidance for the management of abnormal vaginal screening tests. An electronic search of the PubMed database through 2015 was performed. Articles describing vaginal cytology or vaginal hrHPV testing were reviewed, and diagnostic accuracy of these tests when available was noted. The available literature was too limited to develop evidence-based recommendations for managing abnormal vaginal cytology and hrHPV screening tests. However, the data did show that (1) the risk of vaginal cancer in women after hysterectomy is extremely low, justifying the recommendation against routine screening,...Continue Reading

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Citations

Nov 13, 2018·Journal of Lower Genital Tract Disease·Qing CongLong Sui
Aug 12, 2016·The Nurse Practitioner·Barbara A Wuerthner, Maria Avila-Wallace

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