Hot Topics Clinical Medicine ACHA Annual Meeting Boston, MA May 31, 2013

Boston University Slideshow Title Goes Here Important publication-LAST  Consensus Guidelines (2012) The Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions: Background and Consensus Recommendations From the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology  Journal of Lower Genital Tract Disease, July 2012 Hot Topics, Clinical Medicine 2 10/10/2015

Boston University Slideshow Title Goes Here Basic intervals, normal pap history  Don’t start paps until 21  every 3 years, no co-testing  every 3 years or every 5 years with co-testing  Over 65 no testing Hot Topics, Clinical Medicine 3 10/10/2015

Boston University Slideshow Title Goes Here Hot Topics, Clinical Medicine 4 10/10/2015 Unsatisfactory cytology on pap  With liquid-based technology, most reasons for unsatisfactory cytology are eliminated EXCEPT inadequate cells  Don’t use negative HPV co-testing as a reason not to repeat  Repeat test in 2-4 months

Boston University Slideshow Title Goes Here Hot Topics, Clinical Medicine 5 10/10/2015

Boston University Slideshow Title Goes Here Absent EC/TZ  Prior recommendation was early repeat  Under 30, manage as normal  Over 30, co-test or manage as normal  If negative co-test, routine repeat  If positive co-test, repeat cyto+co-test 1 year or  Genotype for 16, 18 Hot Topics, Clinical Medicine 6 10/10/2015

Boston University Slideshow Title Goes Here Hot Topics, Clinical Medicine 7 10/10/2015

Boston University Slideshow Title Goes Here New concept Hot Topics, Clinical Medicine 8 10/10/ , 18?

Boston University Slideshow Title Goes Here  Test Name Result Flag(s) Reference Range Reported Date Footnote  CLINICAL INFORMATION: SEE NOTE  ALL NL PAPS  LMP: 4/6/2013  PREV. PAP: N/A  PREV. BX: N/A  SOURCE: Cervix  STATEMENT OF ADEQUACY: SEE NOTE  Satisfactory for evaluation. Endocervical/transformation zone component present.  INTERPRETATION/RESULT: SEE NOTE  Negative for intraepithelial lesion or malignancy.  INFECTION: SEE NOTE  Shift in vaginal flora suggestive of bacterial vaginosis.  COMMENT: SEE NOTE  This Pap test has been evaluated with computer assisted technology.  CYTOTECHNOLOGIST: SEE NOTE  CXP, CT(ASCP)  HPV DNA (HIGH RISK) DETECTED A (NOT DETECTED)  High-risk HPV types 16,18,31,33,35,39,45,51,52,56,58,59, or 68 may cause cervical cancer or itsprecursors.The analytical performance characteristics of thisassay, when used to test SurePath or vaginal specimens,have been determined by Quest Diagnostics.Methodology: Hybrid Capture with Signal Amplification. Hot Topics, Clinical Medicine 9 10/10/2015

Boston University Slideshow Title Goes Here Hot Topics, Clinical Medicine 10 10/10/2015

Boston University Slideshow Title Goes Here New concept Hot Topics, Clinical Medicine 11 10/10/2015

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Boston University Slideshow Title Goes Here Hot Topics, Clinical Medicine 13 10/10/2015

Boston University Slideshow Title Goes Here Hot Topics, Clinical Medicine 14 10/10/2015