Who Is Getting the LAST Word on Your Cervix?

HPV disease and what to do after a positive HPV test, or after an abnormal pap smear, or after prior treatment for precancerous changes of the cervix has been the subject of a lot of controversy. In the US, almost every strategy we use prevents cervical cancer reliably as long as you are following gyno advice. Ultimately we fail when we don't get the patient in for testing or follow up. But, we are still in search of a way to more reliably go after patients that are likely to progress to cervical cancer, and be able to be patient and wait for HPV disease to resolve if it is likely to not progress to cervical cancer. The newest meeting of the minds that follow this subject closely was in March of 2012, specifically looking at how the cervical biopsies are interpreted. This meeting was called CAP Pathology and Laboratory Quality Center and the ASCCP Consensus Conference: The Lower Anogenital Squamous Terminology Standardization Project (The LAST Project) . Their object is to further refine the way tissue biopsies done after an abnormal pap test are interpreted. They are advocating changes in how those samples are processed to more accurately know the results. There is a new test that laboratories will use called a p16. You may not even know that this p16 test has been used, but if it has been, it's possible there is a more accurate way to interpret what the pathologist reads when they are called upon for a diagnosis. Your gyno may have not yet seen these results, and their laboratories may not yet have adopted these changes, but very likely these changes will be adoped soon, as these experts do have the LAST Word on the biology of your cervix!

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