Dr. Barbara Moscicki discusses the critical role of HPV in women's health, particularly its association with various cancers, including cervical cancer. She explains the dual nature of HPV as both a commensal organism and a pathogen, emphasizing the importance of understanding its oncogenic potential. The conversation also covers the significance of screening methods, such as Pap smears, in detecting precancerous changes and the complexities surrounding the treatment of different cervical intraepithelial neoplasia (CIN) stages. This conversation delves into the complexities of cancer screening methods, particularly focusing on cervical and anal cancer. Dr. Barbara Moscicki discusses the importance of understanding various screening guidelines, the role of HPV vaccination in preventing cancers, and the need for clear communication between clinicians and patients regarding these topics. The discussion highlights the evolving nature of cancer screening practices and the importance of patient education in navigating these changes.
About Our Guest:
Dr. Moscicki is a Pediatrician, Board Certified in Adolescent Medicine. She is the current Division Chief of Adolescent and Young Adult Medicine with clinical expertise in reproductive health care for menstrual irregularities, sexual health, and sexually transmitted diseases. Dr. Moscicki has expertise in HPV -related disease including diagnosis of cervical dysplasia and treatment. She also offers medical care for women with eating disorders.
Dr. Moscicki received her MD at Northwestern University and completed her residency at Vanderbilt Children's Hospital and her fellowship in Adolescent Medicine at UCSF. In addition, she completed a fellowship in STD epidemiology and a molecular virology fellowship at Stanford University as a Howard Hughes Fellow. Prior to coming to UCLA in 2015, Dr. Moscicki was on faculty at UCSF for 30 years.
Dr. Moscicki's 35-year research career has focused on STD epidemiology. A large focus has been on describing the natural history of Human Papilloma Virus in adolescents and young women, transmission dynamics of HPV as well as studying the local and systemic immune responses to HPV. In addition, she has long worked in studying HPV among youth living with HIV. Her work has been translated to public health policies guiding ages to vaccinate with HPV, screening for cervical cancer, and management of abnormal cytology and histology. More recently, her work focuses on the vaginal microbiome and its impact on HPV progression.
Contact Information: AMoscicki@mednet.ucla.edu
Resources & Links:
This episode was supported by the Patient Centered Outcomes Research Institute (PCORI) and features the PCORI research study here: https://www.google.com/url?q=https://pubmed.ncbi.nlm.nih.gov/3 ‘Effect of 2 Interventions on Cervical Cancer Screening Guideline Adherence’
Chapter Codes
00:00 Introduction to HPV and Women's Health
03:00 Understanding HPV's Role in Cancer
06:01 The Dual Nature of HPV: Commensal vs Pathogenic
08:57 Oncogenes and Their Impact on Cellular Regulation
12:09 The Intersection of HPV and Screening Methods
14:58 Cervical Cancer Screening and Pap Smears
20:30 Understanding Cancer Screening Methods
23:17 Guidelines for Cervical and Anal Cancer Screening
31:02 The Importance of HPV Vaccination
39:35 Key Messages for Clinicians and Patients
Takeaways
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Dr. Moscicki specializes in adolescent and young adult medicine.
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HPV is linked to multiple cancers beyond cervical cancer.
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The understanding of HPV's role in cancer has evolved significantly.
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E6 and E7 proteins from HPV disrupt normal cell regulation.
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CIN3 is considered a true pre-cancer that requires treatment.
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Liquid cytology has improved the accuracy of Pap smears.
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CIN1 is often self-resolving and does not require treatment.
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CIN2 presents a diagnostic dilemma due to variability in interpretation.
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Women have options regarding the management of CIN2 lesions.
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Screening and early detection are crucial for cervical cancer prevention. BabsMail is primarily for cervical cancer screening.
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Anal cancer screening is similar to pap smears.
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There is no screening for vulvar or vaginal cancer.
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HPV co-testing has improved cervical cancer detection.
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Vaccination rates are crucial for reducing cancer incidence.
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Guidelines for screening can vary between organizations.
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Self-sampling for HPV testing is becoming more common.
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Communication between providers and patients is essential.
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Understanding different guidelines helps in patient care.
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HPV vaccination can prevent multiple types of cancers.
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Disclaimer:
All content and information provided in connection with Manta Cares is solely intended for informational and educational purposes only. This content and information is not intended to be a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
This episode was supported by an award from the Patient-Centered Outcomes Research Institute.
