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Avoid treatment of CIN 1 in women under age 25.
Choosing Wisely®
American Society for Colposcopy and Cervical Pathology
Regardless of prior cytology, treatment of cervical intraepithelial neoplasia grade 1 (CIN 1) in women aged 21–24 years is not recommended. CIN 1 is the histologic manifestation of HPV infection, and like HPV infection in young women regression rates are high. It is uncommon for these lesions to progress.
ver más ... 2017Don’t order screening tests for low-risk HPV types.
Choosing Wisely®
American Society for Colposcopy and Cervical Pathology
There is no role for testing for low-risk HPV types for cervical cancer screening or patient follow-up for abnormal results. Identification of a low-risk HPV type does not change patient management or treatment. Low-risk HPV tests should not be performed.
ver más ... 2017Don’t perform cervical cytology (Pap tests) or HPV screening in immunocompetent women under age 21.
Choosing Wisely®
American Society for Colposcopy and Cervical Pathology
Cervical cancer is rare in adolescents and screening does not appear to lower that risk. Screening adolescents for cervical cancer exposes them to the potential harms of tests, biopsies, and procedures, without proven benefit.
ver más ... 2017Don’t perform vaginal cytology (Pap test) or HPV screening in women who had hysterectomy (with removal of the cervix) for reasons other than high-grade cervical dysplasia (CIN 2/3) or cancer.
Choosing Wisely®
American Society for Colposcopy and Cervical Pathology
Vaginal cancer after hysterectomy is very rare, less likely than breast cancer for men, for which screening is not recommended. Screening these women is more likely to discover benign changes that prompt invasive testing than to prevent cancer. Continued vaginal cytology (Pap testing) is recommended for women who had a hysterectomy for the indication of high-grade cervical dysplasia or cancer, as their risk of vaginal cancer remains elevated. Vaginal assessment may also be indicated in the ...
ver más ... 2017Don’t routinely use MRI to diagnose bone infection (osteomyelitis) in the foot.
Choosing Wisely®
American Podiatric Medical Association
When the diagnosis of osteomyelitis can be reliably established by clinical means and/or serial plain film radiographs, MRI is generally unnecessary. Furthermore, MRI is particularly poor at differentiating osteomyelitis from benign postoperative marrow edema and from marrow edema due to Charcot arthropathy. Use of MRI in these instances can lead to a false positive interpretation and potentially harmful overtreatment.
ver más ... 2017