title: Guidelines for screening and treatment of cervical disease in the adolescent.
abstract: BACKGROUND
  The last decade has seen a significant increase in our knowledge of HPV infection and its natural history. The advent of liquid-based cytology and HPV testing has changed the way we approach patients with abnormal Pap tests. The objective is to summarize some of the key evidence that lead to the American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines for the management of abnormal cytology and histology and the American Cancer Society (ACS) cervical cancer screening guideline as they pertain to adolescents.
  
  
  METHODS
  The critical publications responsible for the recent ASCCP guidelines as well as the ACS recommendations for cervical cancer screening were reviewed.
  
  
  RESULTS
  Sexually active adolescents are frequently infected by HPV. The natural history of these infections is one with a high rate of resolution. The typical HPV infection will resolve in approximately one year. The ACS has recommended that Pap test screening begin at 21, or 3 years after the onset of sexual activity. The ASCCP guidelines for the management of CIN 1 conclude that observation is the preferred therapy. These recommendations reflect our improved understanding of the natural history of HPV infection.
  
  
  CONCLUSIONS
  Adolescents frequently experience transient HPV infections. As our understanding of the natural history of these infections has improved major national organizations have changed the recommendations for the screening of cervical disease and treatment of low-grade cervical abnormalities. The health care community servicing adolescents should incorporate these recommendations into daily practice.
authors.affiliation: Magee-Women's Hospital, UPMC Health System, Pittsburgh, Pennsylvania 15213, USA. rguido@mail.magee.edu
authors.forename: Richard
authors.initials: R
authors.lastname: Guido
mesh_terms: D000293:Adolescent; D020681:Colposcopes / Q000592:standards; D015344:DNA Probes, HPV; D005260:Female; D006801:Humans; D008403:Mass Screening; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000175:diagnosis; D017410:Practice Guidelines as Topic; D002577:Uterine Cervical Diseases / Q000175:diagnosis* / Q000628:therapy*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000628:therapy
chemical_list: D015344:DNA Probes, HPV