The Natural History and Epidemiology of HPV

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The Natural History and Epidemiology of Human Papillomavirus (HPV)

Presented by Dr. J. Thomas Cox, MD

Release Date of Activity: November 2009
Expiration Date of Activity for AMA PRA Credit: November 30, 2012
Estimated Time to Complete This Activity: 1 hour

Authors and Reviewers Biosketches

To register for the Online CME Series click here

Course Summary and Competency Goals
Human papillomavirus (HPV) is the cause of almost all preneoplastic and neoplastic disorders of the epithelium that lines the lower genital tract. For that reason, understanding the epidemiology and natural history of HPV is critical for all obstetrician-gynecologists, family practitioners, advanced practice clinicians, and dermatologists concerned with the general welfare of their patients, as well as pathologists who supervise residents and fellows and physicians with administrative responsibility for patients. Despite the importance of this virus in the pathogenesis of common disease, many clinicians have a limited understanding of a) the basic biology of HPV and the lesions that it induces, including genital warts and preneoplastic and neoplastic disease of the entire lower genital tract; b) the costs to society, and to the individual, of HPV infections; and c) how to appropriately counsel patients as to HPV infections or lesions, or those with HPV only found on cervical cytology or on molecular HPV testing.

This evidence-based online activity was specifically designed to improve patient care, medical knowledge, practice-based learning, systems-based practice, and interpersonal and communication skills gaps.

Learning Objectives
Upon completion of the learning activity and its post-test, participants should be able to:

Understand the natural history and epidemiology of HPV;
Discuss the reasons for the high prevalence of HPV and the relatively low occurrence of detectable manifestations;
Describe the mechanism by which HPV causes cervical and other lower genital tract cancers;
Implement appropriate management options that best reflect an understanding of the natural history of HPV and, therefore, most likely to benefit the patient; and,
Facilitate counseling about HPV by providing answers to common questions, such as, "Where did I get it?", "How did I get it?", "Will I always have it?", and "What can I do to get rid of it?"

Intended Audience
The Online CME lecture "The Natural History and Epidemiology of HPV" will best serve those physicians and advanced practice clinicians who will be counseling and treating men and women with genital HPV infections manifest as either lesions (genital warts or intraepithelial neoplasia) or only detected cytologically or on sensitive molecular HPV testing. It was designed to meet the CME needs of the practicing obstetrician-gynecologist, family physician, gynecologic oncologist, resident in either obstetrics/gynecology or family practice, pathologist, dermatologist, nurse practitioner, certified nurse midwife, and physician's assistant.

Accreditation Statement
The American Society for Colposcopy and Cervical Pathology (ASCCP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians.

Continuing Medical Education (CME) Credit
The ASCCP designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Management of Conflicts of Interest and Contributed Funds
As an accredited provider of CME credit, ASCCP is required to comply with the ACCME's Standards for Commercial Support and has implemented a management process to ensure that anyone who is in a position to affect the content of the educational activity (e.g., faculty, planners, etc.) has disclosed to us all relevant financial relationships with any commercial interest and has ensured that those relationships do not influence presentation materials. All faculty have agreed to base their presentations on best available evidence. ASCCP discloses to learners any financial relationship(s) to healthcare-related commercial interests existing within the past 12 months to include the following information: 1) the name of the individual; 2) the name of the commercial interest; and, 3) the nature of the relationship the person has with each commercial interest. Slides and slide notes are reviewed for possible bias prior to the activity's release by the Accreditation Committee and peer-reviewers, and potential conflicts of interest are resolved prior to the live presentation. Any discussion of off-label use of products is noted when appropriate, as is discussion of any limitations on the information that is presented, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion. Disclosures of these commitments and/or relationships are published in these lecture materials and provided prior to the start of the activity, so the learners may formulate their own judgments regarding the presentation(s). Under ASCCP policy, anyone declining either to disclose or amend material to eliminate potential bias identified by the Accreditation Committee will be replaced.

Author, Reviewers, and Planners' Disclosure Information
The following are all reported disclosures of interest or potential conflicts from the 12 months preceding this activity:

J. Thomas Cox, MD (Author) - serves on the Data and Safety Monitoring Board for Merck & Co and receives a fee for his service. He is also a scientific advisory board member for Gen-Probe and an advisory board member for Abbott, for both of which he receives an honorarium.
Hope K. Haefner, MD (CME Reviewer) - served on the speakers' bureau for Merck & Co and receives an honoraria. Effective March 2010 forward, she has had no financial relationships or conflicts to disclose.
Beth Colvin Huff, MSN, NP (CME Reviewer) - is a shareholder, receiving dividends with Hologic and serves on the speakers' bureaus of Merck & Co and Qiagen, for which she receives honoraria.

Those reporting no financial relationships or conflict of interest to disclose:
L. Stewart Massad, MD (Accreditation Committee Co-chair/CME Reviewer/Planner)
Herschel W. Lawson, MD (CME Reviewer/Accreditation Committee Co-chair)
Alan G. Waxman, MD (CME Reviewer)
Kathleen Poole (ASCCP Executive Director, Planner)
Carol Noonan (ASCCP Assistant Course Administrator, Planner)

CME Inquiries
For all CME certificate inquiries, please contact Ms. Carol Noonan at cnoonan@asccp.org or by mail at the ASCCP National Office, 152 West Washington Street, Hagerstown, MD 21740 or by phone at 301-733-3640.