Suggested Pap Smear Referral Guidelines (Dec 2007 ) (Prepared by HMC Ambulatory Care Medical Directors)

1. Suggested Pap Smear Referral Guidelines (Dec 2007) (Prepared by HMC Ambulatory Care Medical Directors) Perform Pap Smear If Abnormal If Unsatisfactory Repeat ASCUS (Atypical Squamous Cells of Undetermined Significance) ASC-H (Atypical Squamous Cells rule out High Grade) AGC (Atypical Glandular Cells) HSIL (High Grade Squamous Intraepithelial Lesion) LSIL (Low Grade Squamous Intraepithelial Lesion) HPV not done HPV+ All Others HPV- Select Patients Refer for Colposcopy Adolescents* (with ASCUS) may repeat Pap q12 months x 2 years before referral regardless of HPV result Repeat Pap 6 months Adolescents* may repeat q12 months x 2 years Treat infection or atrophy if indicated and repeat screen one year Adolescents*: repeat Pap q 12 months refer to colposcopy for persistent atypia or LSIL >2year Postmenopausal women: consider estrogen therapy and repeat Pap 6-12 months refer to colposcopy if persistent changes If abnormal *Adolescents refers to women 20 years or younger