Washington, DC -- Clinicians should use a less aggressive course of treatment for abnormal cervical cytology screening (Pap test) results and benign lesions in adolescents than they do in adult women, according to a new Committee Opinion from The American College of Obstetricians and Gynecologists (ACOG). The new guidelines published in the April issue of Obstetrics & Gynecology recommend close monitoring over invasive treatment in cervical cytology management for teens in many cases.

Most human papillomavirus (HPV) infections and abnormal cervical cells will regress without treatment within 13–24 months in adolescents with normal immune function. Due to the high chance of spontaneous resolution and the risk of damage to cervical tissue and future fertility, non-invasive treatment of abnormal cervical cells and lesions in adolescents is recommended whenever possible. Health-conscious teens who comply with their doctor's instructions often can be treated effectively through follow-up cytology screenings in two 6-month intervals or one screening at 12 months.

ACOG recommends that women receive annual cervical cytology screening beginning approximately three years after initiation of sexual intercourse, but no later than age 21. Women younger than 30 should be screened annually. In adolescents, the clinician's assessment of risk factors, such as age of first sexual activity and behaviors that might increase the risk of HPV infection, should guide the decision about when the first cytology screening is performed.

The ACOG Committee Opinion provides a summary of treatment recommendations for adolescents and adults who have abnormal cytology test results. It also outlines consent issues unique to teens, who often received their Pap test during a confidential STD screening or counseling for contraception.

The document was developed by ACOG's Committee on Adolescent Health Care. The recommendations expand on the 2005 Practice Bulletin Management of Abnormal Cervical Cytology and Histology and the 2004 Committee Opinion Cervical Cancer Screening in Adolescents.

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