Acog hpv screening prevention guidelines 2017 download pdf free

There is high certainty that the net benefit is substantial. There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits. Screening for cervical cancer: U. Preventive Services Task Force recommendation statement. Preventive Services Task Force. JAMA ;— Retrieved April 12, Bulk pricing was not found for item.

Please try reloading page. For additional quantities, please contact sales acog. Patient Education Materials For Patients. Featured Clinical Topics. The U. These vaccines cover 2, 4, or 9 HPV serotypes, respectively. Bivalent and quadrivalent vaccines are approved for women and men aged 9—26 years, and the 9-valent vaccine is approved for women and men aged 9—45 years.

The Advisory Committee on Immunization Practices and ACOG recommend routine HPV vaccination for girls and boys at the target age of 11—12 years but it may be given from the age of 9 years as part of the adolescent immunization platform to reduce the incidence of anogenital cancer and genital warts associated with HPV infection 8.

Although obstetrician—gynecologists are not likely to care for many patients in the recommended HPV vaccination target population, they have the opportunity to provide catch-up vaccination for girls and women age 13 and older and to discuss HPV vaccination with parents of children in the target age.

Further, obstetrician—gynecologists and other health care professionals should educate parents in their decision making regarding vaccinations for their daughters and sons.

The target age for HPV vaccination is 11—12 years. For immunocompetent girls and boys who receive their first dose of HPV vaccine before 15 years of age, only two doses are needed because the immune response that develops at this age provides antibody levels equivalent to those in patients who receive three doses at the age of 15 years or older The timing of the two doses is 0 baseline and 6—12 months. The 6-month interval between these two doses is critical for ensuring adequate immune titers and durability of protection.

If the interval between the two doses is less than 5 months, a third dose is recommended 8. Studies show that two doses of HPV vaccine given 6 months apart in individuals aged 9—14 years resulted in antibody titers equal to those in individuals aged 15—26 years who were given three doses. Hence, only two doses, 6—12 months apart, are needed if HPV vaccination is initiated before 15 years of age in boys and girls 5 8. In addition to the ability to use two doses instead of three doses, earlier vaccination also is preferred because HPV vaccines are most effective when given before exposure and infection with HPV, which coincide with the onset of sexual activity.

All of these findings underscore the importance of vaccination at the target age 11—12 years , which is before the onset of potential exposure in the vast majority of adolescents.

Human papillomavirus vaccination is not associated with an earlier onset of sexual activity 15 16 or increased incidence of sexually transmitted infections If girls or boys receive their first dose at age 15 years or older, three doses are needed and given at 0 baseline , 1—2 months after the first dose, and 6 months after the first dose 8. Although the vaccine is less effective in previously infected individuals, it is expected that some benefit will be experienced because prior exposure to all nine vaccine types is highly unlikely 17 Although administration of the HPV vaccine is safe in patients aged 27—45, and can prevent new infections in women not previously exposed to the HPV-type protection generated by the vaccine, most women in this age range will have been exposed to HPV already.

The overall public health benefit of HPV vaccination in women aged 27—45 years is markedly diminished compared with use in the target age range 7. Those women aged 27—45 years who are most likely to benefit from vaccination are those at greater risk for HPV exposure or acquisition: younger women, women who are not in committed monogamous relationships, and women with recently diagnosed sexually transmitted infections.

When counseling patients, clinicians should explain that women aged 27—45 years in long-term monogamous relationships are not likely at risk of acquiring a new HPV infection. It is not routinely recommended that these women receive the vaccine 7.

Clinicians should keep in mind that catch-up HPV vaccination is not recommended for all adults older than 26 years and that HPV vaccination does not need to be discussed with most adults older than 26 years. The American College of Obstetricians and Gynecologists does not recommend that an individual who received the quadrivalent HPV vaccine be revaccinated with 9-valent HPV vaccine, including those aged 27—45 years who previously completed some, but not all, of the vaccine series when they were younger.

In , the rate was By , it decreased to 6. Even if you are not due for cervical cancer screening, you should still see your ob-gyn regularly for birth control counseling, vaccinations, health screenings, prepregnancy care, and the latest information about your reproductive health.

It is not intended as a statement of the standard of care, nor does it comprise all proper treatments or methods of care.

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