A Common Clinical Dilemma: Management of Abnormal Vaginal Cytology and Human Papillomavirus Test Results

@article{Khan2016ACC,
  title={A Common Clinical Dilemma: Management of Abnormal Vaginal Cytology and Human Papillomavirus Test Results},
  author={Michelle J. Khan and Leslie Stewart Massad and Walter Kinney and Michael A. Gold and Edward John Mayeaux and Teresa M. Darragh and Philip E. Castle and David Chelmow and Herschel W. Lawson and Warner K. Huh},
  journal={Journal of Lower Genital Tract Disease},
  year={2016},
  volume={20},
  pages={119–125}
}
ObjectiveVaginal cancer is an uncommon cancer of the lower genital tract, and standardized screening is not recommended. Risk factors for vaginal cancer include a history of other lower genital tract neoplasia or cancer, smoking, immunosuppression, and exposure to diethylstilbestrol in utero. Although cervical cancer screening after total hysterectomy for benign disease is not recommended, many women inappropriately undergo vaginal cytology and/or human papillomavirus (HPV) tests, and… 
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References

SHOWING 1-10 OF 51 REFERENCES
Human Papillomavirus Type-Distribution in Vulvar and Vaginal Cancers and Their Associated Precursors
TLDR
Although the potential effect of HPV vaccines on these gynecologic cancers may not be as high as for cervical cancer due to their more diverse causes, vaccinating young women against HPV16/18 may help to reduce the incidence of HPV-related cases.
A population-based study of squamous cell vaginal cancer: HPV and cofactors.
TLDR
In situ and invasive vaginal neoplasia have many of the same risk factors as cervical cancer, including a strong relationship to HPV infection.
Cytopathological findings on vaginal Papanicolaou smears after hysterectomy for benign gynecologic disease.
TLDR
The prevalence of abnormal findings on cytopathological examination of vaginal Papanicolaou smears after hysterectomy for benign gynecologic disease is extremely low.
A Systematic Review of the Prevalence and Attribution of Human Papillomavirus Types among Cervical, Vaginal, and Vulvar Precancers and Cancers in the United States
TLDR
The HPV type distribution and proportion of cases testing positive for any HPV type were observed to vary among U.S. cervical, vulvar, and vaginal neoplasias and by grade of disease.
Human papillomavirus in vaginal intraepithelial neoplasia
TLDR
Whether those HPV types in the incident VAIN lesions had existed in the vaginal epithelium at the time of the previous cervical neoplasia or a new acquisition needs to be clarified in prospective follow-up studies.
Management of Vaginal Intraepithelial Neoplasia
TLDR
Conservative options in the form of laser ablation and topical agents are useful as first-line treatment methods especially in young women and for multifocal disease.
Clinical features and risk of recurrence among patients with vaginal intraepithelial neoplasia.
TLDR
VAIN occurs most often among women with CIN or VIN, commonly involves the upper third of the vagina, and is often multifocal; partial vaginectomy provides the highest cure rate and multifocality is a risk factor for recurrence.
Human Papillomavirus Genotype Prevalence in Invasive Vaginal Cancer From a Registry-Based Population
TLDR
Three fourths of all vaginal cancers in the United States had HPV detected, much higher than previously found, and 57% could be prevented by current HPV vaccines.
2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors.
TLDR
The group's goal was to provide revised evidence-based consensus guidelines for managing women with abnormal cervical cancer screenings tests, cervical intraepithelial neoplasia (CIN) and adenocarcinoma in situ (AIS) following adoption of cervical cancer screening guidelines incorporating longer screening intervals and co-testing.
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