The ASCCP 2012 Updated Consensus Guidelines for the Management of Abnormal Cervical Cancer Screening Tests and Cancer Precursors App A group of 47 experts representing 23 professional societies, national and international health organizations, and federal agencies met in Bethesda, MD, September 14Y15, 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 neo- plasia (CIN) and adenocarcinoma in situ (AIS) following adoption of cervical cancer screening guidelines incorporat- ing longer screening intervals and co-testing. In addition to literature review, data from almost 1.4 million women in theKaiser 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 in- clude: Human papillomavirusYnegative 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 21Y24 years need less invasive man- agement, 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 circum- stances, even when HPV results from co-testing are known, while most cases of negative cytology with absent or insuf- ficient endocervical cells or transformation zone component can be managed without intensive follow-up. L. Stewart Massad, MD, Mark H. Einstein, MD, Warner K. Huh, MD, Hormuzd A. Katki, PhD, Walter K. Kinney, MD, Mark Schiffman, MD, Diane Solomon, MD, Nicolas Wentzensen, MD, and Herschel W. Lawson, MD, for the 2012 ASCCP Consensus Guidelines Conference From Washington University School of Medicine, St. Louis, Missouri; Albert Einstein College of Medicine, New York, New York; University of Alabama School of Medicine, Birmingham, Alabama; Division of Cancer Epidemiology and Genetics and Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland; The Permanente Medical Group, Sacramento, California; and Emory University School of Medicine, Atlanta, Georgia From the American Society for Colposcopy and Cervical Pathology Journal of Lower Genital Tract Disease, Volume 17, Number 5, 2013, S1YS27.
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