Academy Exchange

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  • 1.  Cervical Cancer Screening

    Posted 15 days ago

    Are the cervical cancer screening guidelines different for people living with HIV after age 65? If they are, can you share the link for guidelines? 

      My  64 years old patient (will be 65 this year) is undetectable, has had normal annual pap smears w/ HPV contesting, and has no history of abnormal pap smears. She also takes Taltz (ixekizumab) for psoriatic arthritis. Can screening be discontinued after age 65 or can she be screened every 2-3 years?



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    Brittany Sanders
    Mc Calla AL
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  • 2.  RE: Cervical Cancer Screening

    Posted 15 days ago
    Yes, they are different for women living with HIV. Screens don't stop at age 65. 

    Save these guidelines: 
    https://clinicalinfo.hiv.gov/en/guidelines/adult-and-adolescent-opportunistic-infection/human-papillomavirus-disease?view=full

    Also for EMR you have to watch for all your female patients being automatically set for next pap in 5 years (default) as opposed to 3 years. 



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    Joshua Rohr
    Seattle WA
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  • 3.  RE: Cervical Cancer Screening

    Posted 15 days ago
    Thank you!





  • 4.  RE: Cervical Cancer Screening

    Posted 15 days ago
    Brittany,
    I recommend:
    1) Fundamentals of HIV Medicine for the HIV Specialist (2021 version)
    2) HIV Primary Guidelines (HIVMA/IDSA) Updated 2020.
    for questions like this.

    These are excellent sources for questions like this.
    David

    --
    W. David Hardy, MD
    Scientific and Medical Consultant
    E-mail: wdavidhardymd@gmail.com
    Telephone:
    310-709-3505 (Mobile)





  • 5.  RE: Cervical Cancer Screening

    Posted 15 days ago
    I think you should think about this by considering how long you think she has to live. If her life expectancy is only a few years there is no point in screening as it would be unlikely to increase her quality of life or life expectancy. If she is otherwise in excellent health and her siblings are alive and well in their 90s I would screen. I have the same issue with the age 70 limit on checking PSA/screening for prostate CA.





  • 6.  RE: Cervical Cancer Screening

    Posted 15 days ago
    You should continue Q 3 years. Judy Davidoff, MD

    Sent from my iPad