Journal
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
Volume 197, Issue 4, Pages 340-345Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.ajog.2007.07.050
Keywords
adenocarcinomas in situ of the cervix; cervical intraepithelial neoplasia; cryotherapy; loop electrosurgical excision procedure; treatment
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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.
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