title: hr-HPV testing in the management of women with ASC-US+ and in the follow-up of women with cytological abnormalities and negative colposcopy. Recommendations of the Italian group for cervical cancer screening (GISCi).
abstract: Compared to spontaneous screening, an organized screening programme is characterized by the presence of protocols and recommendations for all stages including follow-up. Despite the availability of well-functioning screening programmes throughout the country, the follow-up protocol after an abnormal Pap test and negative colposcopy is not clearly defined in Italy, and there is no uniformity of indications. HPV testing for oncogenic human papillomavirus (hr-HPV) has a high negative predictive value (NPV) and high positive predictive value (PPV) for CIN2+ and its employment can reduce follow-up assessments. In order to provide indications about the management of women with ASC-US+ and the follow-up of women with cytological abnormalities and negative colposcopy, a literature analysis was carried out, taking into consideration European and American guidelines and good practice recommendations from the most important scientific associations and regulatory agencies. GISCi (Italian Group for Cervical Screening) drafted recommendations for the management of women with ASC-US, L-SIL, ASC-H, AGC, and H-SIL until their return to the routine screening interval. This protocol can be applied not only in the management of abnormal Pap smears in cytology-based programmes, but also in the management of abnormal Pap test triage after HPV positive test when HPV is the primary screening test. The protocols approved within the screening programmes must have an extensive consensus among all involved professionals, including any that women might meet outside the programme.
authors.affiliation: Istituto per lo studio e la prevenzione oncologica, Firenze. f.carozzi@ispo.toscana.it.
authors.forename: Francesca Maria
authors.initials: FM
authors.lastname: Carozzi
authors.forename: Anna
authors.initials: A
authors.lastname: Iossa
authors.forename: Aurora
authors.initials: A
authors.lastname: Scalisi
authors.forename: Mario
authors.initials: M
authors.lastname: Sideri
authors.forename: Karin Louise
authors.initials: KL
authors.lastname: Andersson
authors.forename: Massimo
authors.initials: M
authors.lastname: Confortini
authors.forename: Annarosa
authors.initials: A
authors.lastname: Del Mistro
authors.forename: Giovanni
authors.initials: G
authors.lastname: Maina
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Ronco
authors.forename: Patrizio
authors.initials: P
authors.lastname: Raggi
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Schiboni
authors.forename: Marco
authors.initials: M
authors.lastname: Zappa
authors.forename: Paolo
authors.initials: P
authors.lastname: Giorgi Rossi
mesh_terms: D055088:Early Detection of Cancer; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008403:Mass Screening / Q000379:methods; D065006:Papanicolaou Test / Q000379:methods; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000150:complications*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000821:virology; D014626:Vaginal Smears / Q000379:methods; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000453:epidemiology* / Q000821:virology