- © 2007 Marshfield Clinic
Human Papillomavirus Infections in Primary Care
- Folashade Ogunmodede, MD,
- Steven H. Yale, MD,
- Bruce Krawisz, MD,
- Gregory C. Tyler, MD and
- Anthony C. Evans, MD, PhD
- Folashade Ogunmodede, MD, Department of Internal Medicine, Marshfield Clinic, 1000 N. Oak Avenue, Marshfield, Wisconsin 54449
- Steven H. Yale, MD, Department of Internal Medicine, Marshfield Clinic, and Clinical Research Center Marshfield Clinic Research Foundation, 1000 N. Oak Avenue, Marshfield, Wisconsin 54449
- Bruce Krawisz, MD, Department of Pathology, Marshfield Clinic, 1000 N. Oak Avenue, Marshfield, Wisconsin 54449
- Gregory C. Tyler, MD, Department of Obstetrics and Gynecology, Marshfield Clinic, 1000 N. Oak Avenue, Marshfield, Wisconsin 54449
- Anthony C. Evans, MD, PhD, Division of Gynecologic Oncology, University of Wisconsin, 600 Highland Avenue, H4/636, Madison, Wisconsin 53792
- Reprint Requests:
Folashade Ogunmodede, MD, Department of Internal Medicine, Marshfield Clinic, 1000 North Oak Avenue, Marshfield, WI 54449, Tel: 715-387-5537, Fax: 715-389-3808, Email: ogunmodede.folashade{at}marshfieldclinic.org
Abstract
Cervical cancer continues to be a leading cause of mortality worldwide. The incidence and mortality associated with invasive cervical cancer have declined significantly in developed countries due to widespread availability of screening with the Papanicolaou (Pap) test. However, the incidence and prevalence of non-invasive cervical intraepithelial neoplasms and genital warts related to oncogenic and nononcogenic strains of human papilloma viruses (HPV) have remained relatively stable. Recent advances in molecular diagnostics have resulted in improved characterization of various HPV types and have led to changes in terminology of Pap test findings. Changes in nomenclature may lead to confusion among primary care providers regarding how best to further evaluate abnormal cytological results. This article provides a concise overview of the approach to the treatment of genital warts and management of abnormal cervical cytology based on guidelines from the American Society of Colposcopy and Cervical Pathology. It also reviews advances in HPV vaccine development and the new recombinant vaccine recently approved for use in the United States.
