2006 consensus guidelines for the management of women with abnormal cervical screening tests.
OBJECTIVE
To provide revised evidence-based consensus guidelines for managing women with abnormal cervical cancer screening test results.


METHODS
A group of 146 experts, including representatives from 29 professional organizations, federal agencies, and national and international health organizations, met in Bethesda, MD, September 18-19, 2006, to develop the guidelines. MAJOR CHANGES IN GUIDELINES: The core recommendations for managing women with atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesions were changed minimally. Postcolposcopy management for women with these cytological abnormalities is now identical. Management recommendations for these conditions did change for "special populations," such as adolescents for whom a more conservative approach incorporating cytological follow-up for 2 years was approved. Core recommendations for managing women with high-grade squamous intraepithelial lesions and atypical glandular cells also underwent only minor modifications. More emphasis is placed on immediate "screen-and-treat" approaches when managing women with high-grade squamous intraepithelial lesion. Testing for high-risk human papillomavirus DNA is incorporated into the management of women with atypical glandular cells after their initial evaluation with colposcopy and endometrial sampling. The 2004 Interim Guidance for the use of human papillomavirus DNA testing as an adjunct to cervical cytology for screening in women 30 years and older was formally adopted with only very minor modifications.


CONCLUSIONS
The 2006 Consensus Guidelines reflect recent data from large clinical trials and advances in technology and are designed to assist clinicians of all subspecialties.
Wright
Thomas C
TC
Department of Pathology, College of Physicians and Surgeons of Columbia University, New York, NY, USA. tcw1@columbia.edu
Massad
L Stewart
LS
Dunton
Charles J
CJ
Spitzer
Mark
M
Wilkinson
Edward J
EJ
Solomon
Diane
D
D000293:Adolescent; D000328:Adult; D000465:Algorithms; D052685:Alphapapillomavirus / Q000235:genetics; D003127:Colposcopy; D004279:DNA, Viral / Q000032:analysis / Q000302:isolation & purification; D004848:Epithelium / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009365:Neoplasm Regression, Spontaneous; D030361:Papillomavirus Infections / Q000175:diagnosis; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000628:therapy; D012680:Sensitivity and Specificity; D002578:Uterine Cervical Dysplasia / Q000145:classification / Q000473:pathology / Q000628:therapy* / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000145:classification / Q000473:pathology / Q000628:therapy* / Q000821:virology; D014626:Vaginal Smears / Q000145:classification*
D004279:DNA, Viral