Cervical Cancer Screening in Morbidly Obese Women
Screening and Follow-up Recommendations
- Providers should document Pap smear results, follow-up appointments, and provide patients with printed information about their screening, as recommended by the Centers for Disease Control and Prevention (CDC) 1, 2
- If a morbidly obese woman is menstruating, the Pap test should be postponed and rescheduled at the earliest opportunity, according to the CDC guidelines 1, 2
- The presence of mucopurulent discharge should not delay testing; the discharge can be carefully removed with a saline-soaked cotton swab before obtaining the specimen, as suggested by the CDC 1, 2
- Women with external genital warts do not need more frequent Pap tests than women without warts, as stated by the CDC 1, 2
- High-grade squamous intraepithelial lesions (SIL) require prompt referral for colposcopy and biopsy, as recommended by the American College of Obstetricians and Gynecologists (ACOG) 3, 1
- For low-grade SIL or atypical squamous cells of undetermined significance (ASCUS), follow-up may include colposcopy or repeat Pap testing depending on clinical circumstances, according to the ACOG guidelines 3, 1