Risk Estimates Supporting the 2019 ASCCP Risk-Based Management Consensus Guidelines

Didem Egemen; Li C. Cheung; Xiaojian Chen; Maria Demarco; Rebecca B. Perkins; Walter Kinney; Nancy Poitras; Brian Befano; Alexander Locke; Richard S. Guido; Amy L. Wiser; Julia C. Gage; Hormuzd A. Katki; Nicolas Wentzensen; Philip E. Castle; Mark Schiffman; Thomas S. Lorey

doi:10.1097/LGT.0000000000000529

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Risk Estimates Supporting the 2019 ASCCP Risk-Based Management Consensus Guidelines

Journal article

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Risk Estimates Supporting the 2019 ASCCP Risk-Based Management Consensus Guidelines

Didem Egemen, Li C. Cheung, Xiaojian Chen, Maria Demarco, Rebecca B. Perkins, Walter Kinney, Nancy Poitras, Brian Befano, Alexander Locke, Richard S. Guido, …

Journal of lower genital tract disease, Vol.24(2), pp.132-143

04/01/2020

DOI: 10.1097/LGT.0000000000000529

PMID: 32243308

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Abstract

Objective The 2019 American Society for Colposcopy and Cervical Pathology Risk-Based Management Consensus Guidelines for the management of cervical cancer screening abnormalities recommend 1 of 6 clinical actions (treatment, optional treatment or colposcopy/biopsy, colposcopy/biopsy, 1-year surveillance, 3-year surveillance, 5-year return to regular screening) based on the risk of cervical intraepithelial neoplasia grade 3, adenocarcinoma in situ, or cancer (CIN 3+) for the many different combinations of current and recent past screening results. This article supports the main guidelines presentation(1) by presenting and explaining the risk estimates that supported the guidelines. Methods From 2003 to 2017 at Kaiser Permanente Northern California (KPNC), 1.5 million individuals aged 25 to 65 years were screened with human papillomavirus (HPV) and cytology cotesting scheduled every 3 years. We estimated immediate and 5-year risks of CIN 3+ for combinations of current test results paired with history of screening test and colposcopy/biopsy results. Results Risk tables are presented for different clinical scenarios. Examples of important results are highlighted; for example, the risk posed by most current abnormalities is greatly reduced if the prior screening round was HPV-negative. The immediate and 5-year risks of CIN 3+ used to decide clinical management are shown. Conclusions The new risk-based guidelines present recommendations for the management of abnormal screening test and histology results; the key risk estimates supporting guidelines are presented in this article. Comprehensive risk estimates are freely available online at https://CervixCa.nlm.nih.gov/RiskTables.

Life Sciences & Biomedicine

Obstetrics & Gynecology

Science & Technology

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Title: Subtitle: Risk Estimates Supporting the 2019 ASCCP Risk-Based Management Consensus Guidelines
Creators: Didem Egemen - Division of Cancer Epidemiology and Genetics
Li C. Cheung - National Cancer Institute
Xiaojian Chen - National Cancer Institute
Maria Demarco - Division of Cancer Epidemiology and Genetics
Rebecca B. Perkins - Boston University
Walter Kinney - Kaiser Permanente
Nancy Poitras - Kaiser Permanente
Brian Befano - Information Management Services
Alexander Locke - Kaiser Permanente
Richard S. Guido - Magee-Womens Hospital
Amy L. Wiser - Oregon Health & Science University
Julia C. Gage - Division of Cancer Epidemiology and Genetics
Hormuzd A. Katki - National Cancer Institute
Nicolas Wentzensen - National Cancer Institute
Philip E. Castle - Albert Einstein College of Medicine
Mark Schiffman - National Cancer Institute
Thomas S. Lorey - Kaiser Permanente
Resource Type: Journal article
Publication Details: Journal of lower genital tract disease, Vol.24(2), pp.132-143
DOI: 10.1097/LGT.0000000000000529
PMID: 32243308
NLM abbreviation: J Low Genit Tract Dis
ISSN: 1089-2591
eISSN: 1526-0976
Publisher: Lippincott Williams & Wilkins
Number of pages: 12
Grant note: Intramural Research Program of the US National Institutes of Health (NIH)/National Cancer Institute (NCI)
Language: English
Date published: 04/01/2020
Academic Unit: Family and Community Medicine
Record Identifier: 9985134038002771

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