HPV Screening and Cervical Cancer

When a woman is diagnosed with advanced cervical cancer despite years of regular gynecological care, the question that must be asked is whether her physicians met the standard of care — whether the right screening was ordered, whether results were communicated, and whether abnormal findings were followed up appropriately. When the answer is no, the consequences may be legally actionable.

Why HPV Testing Is Now the Preferred Standard

The evidence base for HPV-based cervical cancer screening has been building since the 1990s and is now overwhelming. A landmark study published in the New England Journal of Medicine demonstrated that a single round of HPV DNA testing — compared to visual inspection or cytology alone — dramatically reduced the rate of advanced cervical cancer and related mortality. That study was conducted in a resource-limited rural setting where no prior screening had existed, which made its findings all the more powerful: even one round of HPV testing, in a population that had never been screened, produced a measurable reduction in cervical cancer deaths.

In the United States, where women have access to far more sophisticated screening infrastructure, the failure to use available HPV testing tools appropriately is not a resource problem. It is a standard of care problem.

The American Cancer Society (ACS) currently recommends primary HPV testing every five years as the preferred approach for women aged 25 to 65. Co-testing (HPV plus Pap) every five years or Pap smear alone every three years are acceptable alternatives. The key point is that HPV testing — which identifies the virus that causes cervical cancer before cellular changes even develop — is more sensitive than cytology alone and is now the gold standard.

Where Malpractice Occurs in Cervical Cancer Screening

Most cervical cancer malpractice cases fall into one of several recognizable patterns. Understanding these patterns can help women and families evaluate whether a delayed or missed diagnosis was the result of physician negligence.

• Wrong test, wrong interval: A physician who continues ordering Pap smears annually — rather than HPV testing every five years or co-testing per current guidelines — and misses an HPV-positive result may be departing from the standard of care.
• Failure to communicate abnormal results: One of the most devastatingly common failures. A Pap smear or HPV test returns abnormal. The patient is never notified. The result sits in the chart, and the patient — assuming no news is good news — goes years without appropriate follow-up.
• Failure to follow up on abnormal results: The patient is notified of an abnormal result but no colposcopy or biopsy is ordered. A “watch and wait” approach is taken without clinical justification, while precancerous cells progress to invasive cancer.
• Failure to refer persistent high-risk cases: A patient with persistent high-risk HPV or recurring cellular abnormalities who is not referred to a gynecologic oncologist or colposcopist is not receiving appropriate care.
• Laboratory error: A pathologist or cytotechnologist who misreads a cervical cell sample — calling an abnormal slide normal — may be independently liable for the delayed diagnosis.

The Colposcopy Obligation: What Should Happen After an Abnormal Result

An abnormal Pap or HPV result is not an endpoint. It is a starting point for a defined medical protocol. Depending on the type and grade of abnormality, current guidelines from the American Society for Colposcopy and Cervical Pathology (ASCCP) require specific follow-up actions, including:

• Colposcopy — a magnified examination of the cervix — for patients with high-grade abnormalities, persistent low-grade abnormalities, or positive HPV results with certain cytology findings
• Cervical biopsy during colposcopy to obtain tissue for pathological diagnosis
• Endocervical curettage in select cases
• Repeat testing at defined intervals for patients with low-grade findings or HPV-negative results

When a physician receives an abnormal result and fails to order appropriate follow-up — or dismisses the patient with reassurance that “it’s probably nothing” without evidence-based justification — that failure can allow a pre-invasive lesion to develop into invasive cancer. That progression, when caused by a physician’s departure from the standard of care, is the basis for a malpractice claim.

Symptoms That Should Never Be Ignored

Not every cervical cancer case involves a missed screening result. Some patients present with symptoms that should prompt a physician to evaluate for cervical cancer regardless of recent screening history. These include:

• Abnormal vaginal bleeding — between periods, after intercourse, or after menopause
• Persistent pelvic pain or pressure
• Unusual vaginal discharge

A physician who receives a patient complaint about these symptoms and fails to perform an appropriate evaluation — or who dismisses them without investigation — may be departing from the standard of care. We have handled cases in which women reported symptoms to their physicians for a year or more before a cervical cancer diagnosis was finally made.

What We Look for When Evaluating a Pennsylvania Cervical Cancer Malpractice Case

When a potential client contacts us about a cervical cancer diagnosis that may have been delayed, we build a complete timeline of all relevant medical care, including:

• Every Pap smear and HPV test in the patient’s history — the type of test, the date, and the result
• All laboratory reports and how results were communicated — or not communicated — to the patient
• Any follow-up that was recommended and whether it occurred
• The patient’s stage at diagnosis and when the cancer was first clinically detectable
• Any symptoms that were reported and how the physician responded

We work with gynecologic oncologists and cytopathologists who serve as expert witnesses to evaluate the standard of care and the connection between any breach and the patient’s harm. Damages in these cases reflect the difference in treatment burden and survival probability between a timely diagnosis and a delayed one — often a profound difference.

About Lupetin & Unatin, LLC

Lupetin & Unatin is a boutique medical malpractice firm based in Pittsburgh, Pennsylvania. We represent women and families throughout Pennsylvania who were harmed by delayed or missed cervical cancer diagnoses. Our attorneys are Fellows of the American College of Trial Lawyers, recognized by Super Lawyers and Best Lawyers in America, and have recovered millions of dollars for victims of medical negligence. All cases are handled on a full contingency fee basis.