2015 Annual Meeting

American Society for Cytopathology

2015 Annual Meeting

Room CC 302, March 22 2015, 7:30pm to 10:30pm

Christine Booth, George Birdsong, Mark Stoler, R. Marshall Austin, Jerome Belinson

Cervical Cancer Screening: Guidelines, Clinical Practice, and Future Directions

Educational Objective

The ASC’s diverse membership shares a vision of education, research and continuous improvement in the standards and quality of patient care. From the diverse membership, the educational committees of the ASC determine a set of educational standards that guide the committees to determine the educational needs of the cytopathology community. Evaluation of data from prior meetings, changes in the profession and advances in medicine related to pathology/cytopathology are important sources of information used by the education committees to plan ASC educational activities. The programs are reviewed and approved by the ASC Executive Board. While Pap test screening programs have markedly reduced the overall burden of invasive cervical carcinoma in the United States during the past 50 years, cervical carcinoma remains the most common cause of cancer death for women in developing countries. During this same time frame, there have been many changes to the way that US women are screened for cervical cancer. Enhanced understandings of cervical carcinogenesis and the integral roles of oncogenic strains of human papillomaviruses in this disease have led to tests for detection of pooled high-risk HPV types in liquid-based cervical samples as well as HPV genotyping for types 16 and 18. Image-based screening platforms represent another significant change in cervical cancer screening. In 2003, the US Food and Drug Administration (FDA) approved high-risk HPV testing in conjunction with a Pap test to screen women 30 years and older (co-testing). Likewise, cervical screening guidelines and the management of both cytologic abnormalities and HPV test results have become increasingly complex. Most recently in April of 2014, the FDA approved primary HPV screening of women 25 and older as a result of data published from the ATHENA (Addressing the Need for Advanced HPV Diagnostics) trial. This session will serve to educate the audience on the FDA approval process for medical devices and to discuss the validity of screening strategies for cervical carcinoma both in the United States and internationally. Target audience are practicing pathologists, fellows, and residents-in-training. The recent literature evaluation which was used for planning this activity clearly identifies and supports the current topics of our proposal as an educational need. Upon completion of this activity, participants should be better able to:

  • Appreciate the salient aspects of the various protocols most commonly applicable to medical laboratory devices submitted for FDA approval
  • Understand the criteria used by the FDA to determine which of the protocols will be used to evaluate a device
  • Know the tools available to the FDA for following up on the safety and effectiveness of devices after approval
  • Understand data documenting the limitations of primary HPV cervical screening in preventing cervical cancer morbidity and mortality
  • Appreciate the advantages of cytology and HPV co-testing in routine cervical screening
  • Understand the historical record of how changes in cervical screening have occurred over extended periods of time and how this may be relevant in discussions of primary HPV screening
  • Appreciate the critical characteristics of a public health screening program for cervical cancer screening
  • Know the common determinants of program design
  • Understand the importance of a comprehensive system
  • Know the roles for self-collection of HPV samples

Session Credits: CME = 3 / SAMs = N/A


Introduction and Welcome
Speaker: Christine N. Booth, MD, Cleveland Clinic, Cleveland, OH
Companion Meeting Moderator
Speaker: Christine N. Booth, MD, Cleveland Clinic, Cleveland, OH
Handouts: View PDF
FDA Approval of Medical Devices Demystified
Speaker: George G. Birdsong, MD, Emory University, Atlanta, GA
Handouts: View PDF
An Update on Cervical Cancer Screening Algorithms: Should HPV or Cytology be the Primary Test?
Speaker: Mark H. Stoler, MD, University of Virginia, Charlottesville, VA
Handouts: View PDF
The Case for Routine Cervical Screening Utilizing Cytology and HPV Co-Testing
Speaker: R. Marshall Austin, MD, PhD, Magee-Womens Hospital, Pittsburgh, PA
Handouts: View PDF
The Development and Evaluation of a Community Based Model for Cervical Cancer Screening Based on Self-Sampling
Speaker: Jerome L. Belinson, MD, Cleveland Clinic, Cleveland, OH
Handouts: View PDF


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