To the Editor: The new Bethesda Consensus Guidelines
for the Management of Women With Cervical Cytological Abnormalities, which
were described by Dr Wright and Colleagues,1
strongly endorse human papillomavirus (HPV) testing for women with atypical
squamous cells of uncertain significance (ASC-US). This protocol may lead
to a heightened public awareness that cytological abnormalities are caused
by a sexually transmitted infection. While HPV testing is partly justified
by a desire to reduce the discomfort and anxiety associated with colposcopy,
testing may lead to stigma and shame and considerably increase the psychological
burden of cervical screening on women, which could ultimately reduce the advances
made in cervical cancer prevention.
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