by JonN | Oct 1, 2012 | Articles, Guidelines, Obstetrics & Gynecology, Oncology, Primary Care, Recent Features, Slider
In 2012, the United States Preventive Services Task Force (USPSTF) updated screening recommendations for cervical cancer. According to the update, an annual Pap smear is not necessary to prevent deaths from cervical cancer. Screening for cervical cancer is recommended in women aged 21 to 65 with cytology every 3 years. Screening every 3 years starting at age 21 saves the same number of lives as annual screening, but with half the number of colposcopies and fewer false-positive tests. For women aged 30 to 65 who want to lengthen the screening interval, screening with a combination of cytology and HPV testing every 5 years is recommended. “It’s important to balance benefits and potential risks associated with screening.” The USPSTF recommends against screening for cervical cancer in women younger than age 21 and in women older than age 65 who have had adequate prior screening and are not otherwise at high risk for cervical cancer. It also recommends against screening for cervical cancer in women who have had a hysterectomy with removal of the cervix and who do not have a history of a high-grade precancerous lesion or cervical cancer. Screening for cervical cancer with HPV testing, alone or in combination with cytology, is not recommended in women younger than 30. Women who have been vaccinated against HPV infection should be screened in accordance with age-specific recommendations for unvaccinated women. Women who have an abnormal Pap test but negative HPV test can have a Pap test alone in 3 years or co-testing in 5 years. If a Pap test is negative but HPV is positive, women can be screened again with...
by Physicians Weekly | Aug 23, 2012 | Articles, Conference Coverage, HIV/AIDS, Infectious Disease, Recent Features, Slider
New research was presented at AIDS 2012, the 19th International AIDS Conference, from July 22-27 in Washington, DC. The features below highlight just some of the studies that emerged from the conference. Multiple Benefits With Early HIV Treatment The Particulars: Research has indicated that early treatment of HIV helps prevent various adverse outcomes. A landmark trial (HPTN 052) recently found that effective early treatment of HIV appears to help prevent transmission among heterosexuals. Data Breakdown: Two analyses of HPTN 052 were conducted. The first reviewed HIV patients who underwent immediate therapy when compared with those whose treatment began after CD4 counts fell below 250 cells/mm3. Immediate therapy was associated with longer time to an AIDS-defining event and to tuberculosis. The second analysis, conducted in similar patients, found that early HIV treatment was cost-effective, and in some cases, perhaps less expensive than delaying therapy. Take Home Pearls: Early treatment of HIV appears to reduce the risk of AIDS-defining events and tuberculosis. Early treatment also appears to be cost-effective. HIV/HCV Co-Infection & Outcomes The Particulars: HIV has been shown in previous studies to accelerate hepatitis C virus (HCV) progression. Whether antiretroviral therapy (ART) slows this progression has not been explored in clinical trials. Data Breakdown: In a study, the outcomes of patients with HIV/HCV co-infection—all of whom were on ART—were compared with those of patients with HCV only. Co-infected patients had a 6.3% rate of hepatic decompensation, compared with 5.0% for those with HCV only. Hepatocellular carcinoma developed in 1.2% of co-infected patients, compared with 0.9% of HCV patients. The mortality rate was 32.9% for co-infected patients, compared with 15.4% for...
