2006 consensus guidelines for the management of women with cervical intraepithelial neoplasia or adenocarcinoma in situ

A group of 146 experts representing 29 organizations and professional societies met Sept. 18-19, 2006, in Bethesda, MD, to develop revised evidence-based, consensus guidelines for managing women with abnormal cervical cancer screening tests. The management of low-grade cervical intraepithelial neopl...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2007-10, Vol.197 (4), p.340-345
Main Authors: Wright, Thomas C., MD, Massad, L. Stewart, MD, Dunton, Charles J., MD, Spitzer, Mark, MD, Wilkinson, Edward J., MD, Solomon, Diane, MD
Format: Article
Language:English
Subjects:
Adenocarcinoma - pathology
Adenocarcinoma - surgery
adenocarcinomas in situ of the cervix
Adolescent
Adult
Carcinoma in Situ - pathology
Carcinoma in Situ - surgery
cervical intraepithelial neoplasia
Cervical Intraepithelial Neoplasia - pathology
Cervical Intraepithelial Neoplasia - surgery
Colposcopy
Conization
cryotherapy
Electrosurgery
Female
Humans
loop electrosurgical excision procedure
Obstetrics and Gynecology
Pregnancy
treatment
Uterine Cervical Neoplasms - pathology
Uterine Cervical Neoplasms - surgery
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Summary:A group of 146 experts representing 29 organizations and professional societies met Sept. 18-19, 2006, in Bethesda, MD, to develop revised evidence-based, consensus guidelines for managing women with abnormal cervical cancer screening tests. The management of low-grade cervical intraepithelial neoplasia (CIN) grade 1 has been modified significantly. Previously, management depended on whether colposcopy was satisfactory and treatment using ablative or excisional was acceptable for all women with CIN 1. In the new guidelines, cytological follow-up is the only recommended management option for women with CIN 1 who have low-grade referral cervical cytology, regardless of whether the colposcopic examination is satisfactory. Treatment is particularly discouraged in adolescents. The basic management of women in the general population with CIN 2,3 underwent only minor modifications, but options for the conservative management of adolescents with CIN 2,3 have been expanded. Moreover, management recommendations for women with biopsy-confirmed adenocarcinoma in situ are now included.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2007.07.050