Guidelines - Manage Cervical Cytological Abnormalities

Wright, Thomas

Abstract

Each year approximately 50 million Papanicolaou smears are taken in the United States and of these, approximately 7% are classified as abnormal. Currently there are no nationally accepted guidelines for management of women with abnormal Papanicolaou smears and cervical cancer precursors. Moreover, most guidelines that have been published by individual societies/organizations are out of date since the do not incorporate recent changes in our understanding of the pathogenesis and natural history of cervical cancer and its precursors, or address recent technological innovations such as liquid-based cytology and HIV DNA testing. The lack of up-to-date national guidelines is causing widespread confusion among both health care providers and patients as to how best to manage abnormal Papanicolaou smears and cervical cancer precursors, and appears to be producing widely varying approaches to clinical care. The American Society of Colposcopy and Cervical Pathology (ASCAP) will hold a workshop on September 6-9, 2001 in Bethesda, MD at the NIH to develop Consensus Guidelines for the Management of Cytological Abnormalities and Cervical Cancer Precursors. The objective of the workshop is to develop comprehensive, evidence-based guidelines to guide clinicians of all subspecialties of medicine and nursing. Representatives from the American Academy of Family Physicians, American Cancer Society , American College Health Association, American College of Obstetricians and Gynecologists, American Society for Clinical Pathologists, American Society for Cytopathology, Am. Social Health Association, Centers for Disease Control and Prevention, Eurogin, International Academy of Cytology, International Federation of Cervical Pathology and Colposcopy, International Society of Gynecologic Pathologists, National Cancer Institutes, Nurse Practitioners in Women's Health, Pan American Health Organization, Planned Parenthood Federation of America, Society of Canadian Colposcopists, and Society of Gynecologic Oncologists will participate in the workshop. The participation of these diverse and prestigious societies/organizations in the development of the management guidelines should insure their widespread acceptance.