Updated Guidelines for Papanicolaou Tests, Colposcopy, and Human Papillomavirus Testing in Adolescents

Worldwide, cervical cancer is a major health concern for women of all ages; however the epidemiology and biology of human papillomavirus (HPV) infection differs in female adolescents and adults. In the United States, 50% of adolescent and young women acquire HPV within 3 years after initiating sexual intercourse, resulting in relatively high prevalence rates. Most infections, however, are transient and clear within several months. Consequently HPV infections detected in adolescents are likely to reflect benign disease, whereas infections detected in older women are likely to reflect persistent infections and a higher risk of advanced cervical intraepithelial lesions that can lead to invasive cervical cancer. This article reviews the most recently published guidelines for the prevention of cervical cancer through screening and management of abnormal cervical cytologic and histologic findings, which have been updated to reflect the differences in HPV infections and cervical abnormalities in female adolescents and adults.