2012 Updated Consensus Guidelines for the Management of Abnormal Cervical Cancer Screening Tests and Cancer Precursors

被引:835
作者
Massad, L. Stewart
Einstein, Mark H.
Huh, Warner K.
Katki, Hormuzd A.
Kinney, Walter K.
Schiffman, Mark
Solomon, Diane
Wentzensen, Nicolas
Lawson, Herschel W.
机构
[1] Washington Univ, Sch Med, St Louis, MO 63110 USA
[2] Albert Einstein Coll Med, New York, NY USA
[3] Univ Alabama Birmingham, Sch Med, Birmingham, AL USA
[4] NCI, Div Canc Epidemiol & Genet, Bethesda, MD 20892 USA
[5] NCI, Canc Prevent Div, Bethesda, MD 20892 USA
[6] Permanente Med Grp Inc, Sacramento, CA USA
[7] Emory Univ, Sch Med, Atlanta, GA USA
关键词
ADENOCARCINOMA IN-SITU; HUMAN-PAPILLOMAVIRUS INFECTION; ATYPICAL GLANDULAR CELLS; OF-AMERICAN-PATHOLOGISTS; SQUAMOUS INTRAEPITHELIAL LESIONS; WOMEN AGED 21; 5-YEAR RISKS; ENDOCERVICAL CURETTAGE; UNDETERMINED SIGNIFICANCE; COMPARISON PROGRAM;
D O I
10.1097/AOG.0b013e3182883a34
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
A group of 47 experts representing 23 professional societies, national and international health organizations, and federal agencies met in Bethesda, MD, September 14-15, 2012, to revise the 2006 American Society for Colposcopy and Cervical Pathology Consensus Guidelines. The group's goal was to provide revised evidence-based consensus guidelines for managing women with abnormal cervical cancer screening tests, cervical intraepithelial neoplasia (CIN) and adenocarcinoma in situ (AIS) following adoption of cervical cancer screening guidelines incorporating longer screening intervals and co-testing. In addition to literature review, data from almost 1.4 million women in the Kaiser Permanente Northern California Medical Care Plan provided evidence on risk after abnormal tests. Where data were available, guidelines prescribed similar management for women with similar risks for CIN 3, AIS, and cancer. Most prior guidelines were reaffirmed. Examples of updates include: Human papillomavirus-negative atypical squamous cells of undetermined significance results are followed with co-testing at 3 years before return to routine screening and are not sufficient for exiting women from screening at age 65 years; women aged 21-24 years need less invasive management, especially for minor abnormalities; postcolposcopy management strategies incorporate co-testing; endocervical sampling reported as CIN 1 should be managed as CIN 1; unsatisfactory cytology should be repeated in most circumstances, even when HPV results from co-testing are known, while most cases of negative cytology with absent or insufficient endocervical cells or transformation zone component can be managed without intensive follow-up. (Obstet Gynecol 2013;121:829-46) DOI: http://10.1097/AOG.0b013e3182883a34
引用
收藏
页码:829 / 846
页数:18
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