••• CHAPTER 65^ ACOG Screening Guidelines Since 2007^653
❍ Which populations should be screened more frequently?
HIV positive
DES exposed
Immunocompromised
History of CIN2-3 and carcinoma
❍ How should women with HIV be screened?
Women with HIV should be screened at the age of diagnosis, twice in that first year and yearly thereafter.
❍ Why is screening over the age of 65 years old ineffective?
There is a very low risk of progression to cancer in women with newly inquired infections and there are more false
positives 2/2 vaginal atrophy in postmenopausal women
❍ When is it appropriate to discontinue screening in women with a hysterectomy?
When the woman has never had CIN2 or higher and the cervix is removed.
❍ When should women with a hysterectomy with a cervix or history of CIN2 or higher stop cervical cancer
screening?
Women should be screened for 20 years with cytology every 3 years after the treatment of CIN 2 or greater.
❍ What carcinoma is the leading cause of death in women in the United States?
Lung cancer.
❍ What carcinoma is the second leading cause of death in women in the United States?
Breast cancer.
❍ What is the lifetime risk of developing female breast cancer?
12% or 1 in 8 women.
❍ How many women are diagnosed with breast caner each year?
Approximately 200,000.
❍ What are the components of breast cancer screening?
Breast imaging, clinical breast examination, and self-awareness or self-examination.
❍ What is the difference between breast self-examination and self-awareness?
Breast self-examination describes monthly self-breast examinations and breast awareness describes familiarity with
one’s own breast without scheduled self-examination.
❍ Which organizations endorse breast imaging, breast self-awareness, and clinical examination as the standard
screening modality?
ACOG, National Comprehensive Cancer Network, and American Cancer Society.