Cervical Cancer Prevention/Screening

      An 18-year-old is accompanied by her mother for her first visit to the gynecologist. She has never been sexually active. She has no concerns with her menses. Her mom reports that she brought her in “because she is 18 and when I turned 18, I had to get my first Pap smear.” Her mother requests the patient have a Pap smear and be tested for HPV “just in case.” The patient is up to date on all vaccines "mandatory for school" but has never had the HPV vaccine. 1. What are the recommendations on the HPV vaccine? 2. How would you counsel this patient about the HPV vaccine? 3. What are the current ASCCP guidelines for Pap smears and HPV testing? 4. How will you explain the rationale to the patient and the mother?