1. Clinical Case and Discussion Questions
Issue #68 Cytology versus HPV testing for cervical cancer screening in the general population
Clinical Case and Discussion Questions
Created by William E Cayley, Jr
Journal Club Editor
Prevea Family Medicine Residency

2. Beth
Beth is a 35 year old woman who has come to see you for routine preventive care.
She has no acute medical concerns, and her history is significant only for 2 pregnancies that ended with normal vaginal deliveries.
She does not smoke or drink alcohol, and she currently lives with her husband and 2 children.

3. Beth
While she has been generally healthy, she has avoided “having a physical” for the last few years in part due to her dislike of pelvic exams.
She finally decided to come today because a friend was recently diagnosed with “pre- cancer” of the cervix, and Beth is concerned whether she should be checked.

4. Beth
She says she is willing to have a pelvic exam for a “pap test” if you, as her physician, think it important.
However, she also says she has heard of “new ways to check for cervical cancer” and that “pap tests may not be needed anymore.”

5. Beth
In order to provide her the most up-to-date evidence on screening methods for cervical cancer, you search the Cochrane Library and find a review entitled:
Cytology versus HPV testing for cervical cancer screening in the general population

6. Questions for discussion
How will you share the results of the Cochrane Review with Beth?
What do the findings from the Cochrane Review say with her respect to her concern as to whether pelvic exams are necessary for screening?
What do the findings of the Cochrane Review tell us about the safety of relying on newer methods of cervical cancer screening?
What do the findings of the Cochrane Review tell us about the accuracy of relying on newer methods of cervical cancer screening?

7. Further Information How to cite the Cochrane Review:
Koliopoulos G, Nyaga VN, Santesso N, Bryant A, Martin-Hirsch PPL, Mustafa RA, Schünemann H, Paraskevaidis E, Arbyn M. Cytology versus HPV testing for cervical cancer screening in the general population. Cochrane Database of Systematic Reviews 2017, Issue 8. Art. No.: CD DOI: / CD pub2.
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