Grand Rounds: How, when, and why to manage cervical dysplasia in adolescents
HPV infection is on the rise in teens and typically transient—yet it still raises the risk of dysplasia. The authors offer evidence-based yet practical guidelines for this management challenge.
The role of HPV
When to screen?
The goal of cervical cancer screening is to identify significant preinvasive lesions and prevent development of invasive cervical cancer. Age 18 has traditionally been accepted as the time to start cytologic screening, but recent consensus panels have recommended initiating screening later. The benchmark now is 3 years after the onset of sexual activity, but not later than age 21.12-14 This recommendation is based on the natural history of HPV infection and the rarity of cervical cancer in adolescents. The incidence of cervical cancer is 0 per 100,000 per year in girls aged 10 to 14 and 1.7 per 100,000 for those aged 15 to 19, according to the Surveillance, Epidemiology, and End Results database.15 Earlier screening is unlikely to add additional benefit and may lead to overtreatment of lesions that would spontaneously regress.
Cesarean delivery reduces mortality risk in preterm breech births
December 2nd 2024In a recent study, infants born very preterm or extremely preterm had reduced odds of mortality when cesarean delivery was chosen as the mode of delivery, without a notable increase in any morbidity risk.
Read More
Early preterm birth risk linked to low PlGF levels during pregnancy screening
November 20th 2024New research highlights that low levels of placental growth factor during mid-pregnancy screening can effectively predict early preterm birth, offering a potential tool to enhance maternal and infant health outcomes.
Read More
Major congenital malformations not linked to first trimester tetracycline use
November 20th 2024A large population-based study found that first-trimester tetracycline exposure does not elevate the risk of major congenital malformations, though specific risks for nervous system and eye anomalies warrant further research.
Read More
No link found between prenatal cannabis use and childhood developmental delay
November 5th 2024In a recent study, offspring of women with cannabis use in early pregnancy confirmed by self-report or toxicology test were not at an increased risk of childhood early developmental delay up to the age of 5.5 years.
Read More
