European guidelines for clinical management of abnormal cervical cytology, part 2.
The current paper presents the second part of chapter 6 of the second edition of the European Guidelines for Quality Assurance in Cervical Cancer Screening. The first part of the same chapter was published in a previous issue (Cytopathology 2008;19:342-54). This part provides guidance on how to manage and treat women with histologically confirmed cervical intraepithelial neoplasia. The paper describes the characteristics, indications and possible complications of excisional and ablative treatment methods. The three options to monitor the outcome after treatment (repeat cytology, HPV testing and colposcopy) are discussed. Specific recommendations for particular clinical situations are provided: pregnancy, immuno-suppression, HIV infection, post-menopause, adolescence and cyto-colpo-histological disparity. The paper ends with recommendations for quality assurance in patient management and some general advice on how to communicate screening, diagnosis and treatment results to the woman concerned. Finally, a data collection form is attached.
Jordan
J
J
Birmingham Women's Hospital, Birmingham, UK. j.jordan@tiscali.co.uk
Martin-Hirsch
P
P
Arbyn
M
M
Schenck
U
U
Baldauf
J-J
JJ
Da Silva
D
D
Anttila
A
A
Nieminen
P
P
Prendiville
W
W
D002584:Cervix Uteri / Q000166:cytology / Q000473:pathology*; D003127:Colposcopy; D055088:Early Detection of Cancer; D005060:Europe; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods; D010349:Patient Compliance; D011247:Pregnancy; D011787:Quality of Health Care; D016896:Treatment Outcome; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000473:pathology / Q000628:therapy