Colposcopic Management of Abnormal Cervical Cytology and Histology
284 - Published December 2012
Objective: To provide a guideline for managing abnormal cytology
results after screening for cervical cancer, to clarify the appropriate
algorithms for follow-up after treatment, and to promote the best
possible care for women while ensuring efficient use of available
Outcomes: Women with abnormal cytology are at risk of developing
cervical cancer; appropriate triage and treatment will reduce
this risk . This guideline will facilitate implementation of common
standards across Canada, moving away from the current trend of
individual guidelines in each province and territory .
Evidence: Published literature was retrieved through searches of
PubMed or Medline, CINAHL, and The Cochrane Library in October
2008 using appropriate controlled vocabulary (e .g ., colposcopy,
cervical dysplasia) and key words (e .g ., colposcopy management,
CIN, AGC, cervical dysplasia, LEEP, LLETZ, HPV testing, cervical
dysplasia triage) . Results were restricted to systematic reviews,
randomized control trials/controlled clinical trials, and observational
studies . There were no date or language restrictions . Searches were
updated on a regular basis and incorporated in the guideline to July
2012 . Grey (unpublished) literature was identified through searching
the websites of health technology assessment and health technology
assessment-related agencies, clinical practice guideline collections,
and national and international medical specialty societies .
Expert opinion from published peer-reviewed literature and
evidence from clinical trials is summarized . Consensus opinion is
outlined when evidence is insufficient .
Values: The quality of the evidence is rated using the criteria described
by the Canadian Task Force on Preventive Health
Care (Table 1) .
Validation: This guideline has been reviewed for accuracy from content
experts in cytology, pathology, and cervical screening programs .
Guideline content was also compared with similar documents from
other organizations including the American Society for Colposcopy and
Cervical Pathology, the British Society for Colposcopy and Cervical
Pathology, and the European Cancer Network