Colposcopic Management of Abnormal Cervical Cytology and Histology

Abstract Objective To provide a guideline for managing abnormal cytology results after screening for cervical cancer, to clarify the appropriate algorithms for follow-up after treatment, and to promote the best possible care for women while ensuring efficient use of available resources. Outcomes Wom...

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Veröffentlicht in:	Journal of obstetrics and gynaecology Canada 2012-12, Vol.34 (12), p.1188-1202
Hauptverfasser:	Bentley, James, MB ChB, Bertrand, Monique, MD, Brydon, Lizabeth, MD, Gagné, Hélène, MD, Hauck, Brian, MD, Mayrand, Marie-Hélène, MD, McFaul, Susan, MD, Power, Patti, MD, Schepansky, Alexandra, MD, Straszak-Suri, Marina, MD, Colgan, Terry, MD, Geldenhuys, Laurette, MD, Heywood, Mark, MD, Howlett, Roberta, PhD, Kapusta, Linda, MD, Kupets, Rachel, MD, Murphy, Joan, MD, Nation, Jill, MD, Senikas, Vyta, MD, Shier, Michael, MD
Format:	Artikel
Sprache:	eng
Schlagworte:	abnormalities cervical cancer Cervical cytology colposcopy Colposcopy - methods Cytodiagnosis - methods Disease Management Female follow-up guidelines Humans Mass Screening - methods Obstetrics and Gynecology Precancerous Conditions - diagnosis Precancerous Conditions - pathology Precancerous Conditions - therapy Risk Adjustment treatment Uterine Cervical Neoplasms - diagnosis Uterine Cervical Neoplasms - pathology Uterine Cervical Neoplasms - therapy
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Zusammenfassung:	Abstract Objective To provide a guideline for managing abnormal cytology results after screening for cervical cancer, to clarify the appropriate algorithms for follow-up after treatment, and to promote the best possible care for women while ensuring efficient use of available resources. Outcomes Women with abnormal cytology are at risk of developing cervical cancer; appropriate triage and treatment will reduce this risk. This guideline will facilitate implementation of common standards across Canada, moving away from the current trend of individual guidelines in each province and territory. Evidence Published literature was retrieved through searches of PubMed or Medline, CINAHL, and The Cochrane Library in October 2008 using appropriate controlled vocabulary (e.g., colposcopy, cervical dysplasia) and key words (e.g., colposcopy management, CIN, AGC, cervical dysplasia, LEEP, LLETZ, HPV testing, cervical dysplasia triage). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date or language restrictions. Searches were updated on a regular basis and incorporated in the guideline to July 2012. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, and national and international medical specialty societies. Expert opinion from published peer-reviewed literature and evidence from clinical trials is summarized. Consensus opinion is outlined when evidence is insufficient. Values The quality of the evidence is rated using the criteria described by the Canadian Task Force on Preventive Health Care (Table 1). Validation This guideline has been reviewed for accuracy from content experts in cytology, pathology, and cervical screening programs. Guideline content was also compared with similar documents from other organizations including the American Society for Colposcopy and Cervical Pathology, the British Society for Colposcopy and Cervical Pathology, and the European Cancer Network.
ISSN:	1701-2163
DOI:	10.1016/S1701-2163(16)35468-8