What are the ASCCP recommendations for the management of abnormal cervical cancer screening results?

Updated: Feb 12, 2019
  • Author: Cecelia H Boardman, MD; Chief Editor: Warner K Huh, MD  more...
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Answer

In 2013, both the American Society for Colposcopy and Cervical Pathology (ASCCP) and the American Congress of Obstetricians and Gynecologists (ACOG) released updated guidelines for managing women with abnormal cervical cancer screening results and diagnosed cancer precursors.

ASCCP and ACOG each provided detailed management algorithms for the following scenarios: [58, 106]

  • Women age 30 or older who are cytology negative but HPV positive
  • Women with atypical squamous cells of undetermined significance (ASC-US) on cytology
  • Women 21-24 years of age with either ASC-US or low-grade squamous intraepithelial lesion (LSIL)
  • Women with LSIL
  • Women 21-24 years of age with atypical squamous cells, cannot rule out high-grade SIL (ASC-H) and high-grade squamous intraepithelial lesion (HSIL)
  • Women with HSIL
  • Initial workup of patients with atypical glandular cells (AGC)
  • Subsequent management of patients with AGC
  • Women with no lesion or biopsy-confirmed grade 1 cervical intraepithelial neoplasia (CIN1) preceded by "lesser abnormalities"
  • Women with no lesion or biopsy-confirmed CIN1 preceded by ASC-H or HSIL cytology
  • Women 21-24 years of age with no lesion or biopsy-confirmed CIN1
  • Young women with biopsy-confirmed grade 2 or 3 cervical intraepithelial neoplasia (CIN 2,3)
  • Young women with biopsy-confirmed CIN 2,3 in special circumstances

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