SOURCES: American College of Obstetrics and Gynecology: "New Cervical Cancer Screening Guidelines." News Release: "HPV Infection Common Among Females in .," Journal of the American Medical Association . American Cancer Society: "Detailed Guide: Cervical Cancer: What Are the Risk Factors for Cervical Cancer?" "Frequently Asked Questions About HPV Vaccines," and "What Are the Key Statistics About Cervical Cancer?" CDC: "HPV and HPV Vaccine: Information for Healthcare Providers." Richard Pan, MD, associate professor of pediatrics, University of California, Davis. Michael Brady, MD, American Academy of Pediatrics spokesman. Associated Press: "Virginia to Require Vaccine for Girls." News-: "Merck Lobbying States to Mandate Gardasil for School Girls."
Differences in women's lifetime cancer risk varied little between screening strategies; however, the difference between the strategy offering the least and most frequent referrals for colposcopy (a procedure in which physicians look directly at the cervix through a microscope) was three-fold. For a representative group of 1,000 20-year-old women undergoing annual screening for 10 years, combined cytologic and HPV testing would lead to an estimated 1,795 referrals for colposcopy and other follow-up procedures (1,788 of them excessive, or not associated with cancer). The same women would receive 403 referrals (396 excessive) from cytologic testing following by triage HPV testing for those with abnormalities; 333 referrals (326 excessive) from conventional cytologic testing; and 223 referrals (216 excessive) from HPV testing followed by cytologic triage testing.