Pap smear screening for adolescents: rationale, technique, and follow-up

Cervical cytologic abnormalities are increasingly prevalent in teenagers. Adolescents are at greater risk for cervical neoplasia than adult women because of the biologic changes occurring in the cervix during puberty, the prevalence of human papillomavirus, and the behavioral risk factors in this age group. Two behavioral risk factors are early age at first coitus and multiple sex partners. Human papillomavirus is widely believed to be the etiologic agent associated with the spectrum of cervical neoplasias. Papanicolaou smear technique, reporting, and management of abnormal smears in teens is explained.