Summary of Current Guidelines for Cervical Cancer Screening and Management of Abnormal Test Results: 2016–2020

医学 阴道镜检查 指南 宫颈癌筛查 危险分层 癌症筛查 混乱 风险评估 重症监护医学 风险管理 妇科 宫颈癌 癌症 病理 内科学 心理学 计算机安全 管理 计算机科学 精神分析 经济
作者
Rebecca B. Perkins,Richard Guido,Mona Saraiya,George F. Sawaya,Nicolas Wentzensen,Mark Schiffman,Sarah Feldman
出处
期刊:Journal of Womens Health [Mary Ann Liebert]
卷期号:30 (1): 5-13 被引量:34
标识
DOI:10.1089/jwh.2020.8918
摘要

Cervical cancer can be prevented through routine screening and follow-up of abnormal results. Several guidelines have been published in the last 4 years from various medical societies and organizations. These guidelines aim to personalize screening and management, reducing unnecessary testing in low-risk patients and managing high-risk patients with more intensive follow-up. However, the resulting complexity can lead to confusion among providers. The CDC, NCI, and obstetrician-gynecologists involved in guideline development summarized current screening and management guidelines. For screening, guidelines for average-risk and high-risk populations are summarized and presented. For management, differences between the 2012 and 2019 consensus guidelines for managing abnormal cervical cancer screening tests and cancer precursors are summarized. Current screening guidelines for average-risk individuals have minor differences, but are evolving toward an HPV-based strategy. For management, HPV testing is preferred to cytology because it is a more sensitive test for cancer precursor detection and also allows for precise risk stratification. Current risk-based screening and management strategies can improve care by reducing unnecessary tests and procedures in low-risk patients and focusing resources on high-risk patients. Knowledge of screening and management guidelines is important to improve adherence and avoid both over- and under-use of screening and colposcopy.
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