Preparing for the Next Round of ASCCP-Sponsored Cervical Screening and Management Guidelines

Schiffman, Mark; Wentzensen, Nicolas; Khan, Michelle J.; Castle, Philip E.; Chelmow, David; Huh, Warner K.; Moscicki, Anna Barbara; Stockdale, Colleen K.; Darragh, Teresa M.; Silver, Michelle I.; Guido, Richard S.

doi:10.1097/lgt.0000000000000300

Cited by 26 publications

(18 citation statements)

References 11 publications

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“…Many other countries, especially those with organized screening programs, follow mild abnormalities like LSIL (watchful waiting) until there is evidence of persistence. Increasing prevalence of HPV vaccination and the identification of new biomarkers may change screening and diagnostic practices …”

Section: Resultsmentioning

confidence: 99%

“…Increasing prevalence of HPV vaccination and the identification of new biomarkers may change screening and diagnostic practices. 75,76 Colposcopy is the primary diagnostic approach for a positive cervical cancer screen (Table 1) [41][42][43][44][45][46][47][48] and includes endocervical sampling when endocervical canal extension is suspected, such as atypical glandular cells or adenocarcinoma in situ. 43 Colposcopy performance is variable because of subjectivity in where and how many biopsies are taken, and low-quality procedures may lead to false reassurance.…”

Section: Cervical Cancermentioning

confidence: 99%

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Timely follow‐up of positive cancer screening results: A systematic review and recommendations from the PROSPR Consortium

Doubeni

Gabler

Wheeler

et al. 2018

CA A Cancer J Clinicians

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Timely follow-up for positive cancer screening results remains suboptimal, and the evidence base to inform decisions on optimizing the timeliness of diagnostic testing is unclear. This systematic review evaluated published studies regarding time to follow-up after a positive screening for breast, cervical, colorectal, and lung cancers. The quality of available evidence was very low or low across cancers, with potential attenuated or reversed associations from confounding by indication in most studies. Overall, evidence suggested that the risk for poorer cancer outcomes rises with longer wait times that vary within and across cancer types, which supports performing diagnostic testing as soon as feasible after the positive result, but evidence for specific time targets is limited. Within these limitations, we provide our opinion on cancer-specific recommendations for times to follow-up and how existing guidelines relate to the current evidence. Thresholds set should consider patient worry, potential for loss to follow-up with prolonged wait times, and available resources. Research is needed to better guide the timeliness of diagnostic follow-up, including considerations for patient preferences and existing barriers, while addressing methodological weaknesses. Research is also needed to identify effective interventions for reducing wait times for diagnostic testing, particularly in underserved or low-resource settings. CA Cancer J Clin 2018;68:199-216. © 2018 American Cancer Society.

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Section: Resultsmentioning

confidence: 99%

Section: Cervical Cancermentioning

confidence: 99%

Timely follow‐up of positive cancer screening results: A systematic review and recommendations from the PROSPR Consortium

Doubeni

Gabler

Wheeler

et al. 2018

CA A Cancer J Clinicians

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“…With HPV testing, cytology, and other available tests, we can now predict risk of cervical precancer and cancer with unprecedented precision. Recent screening and management guideline efforts have adapted a risk‐based approach to screening, management, and treatment that focuses on using risk rather than assay‐specific results to guide clinical management . The approach follows the principle of equal management of equal risks, meaning that, independent of how a certain risk level is arrived at, the management is the same.…”

Section: Application Of Biomarkers For Screening Early Detection Anmentioning

confidence: 99%

“…Recent screening and management guideline efforts have adapted a risk-based approach to screening, management, and treatment that focuses on using risk rather than assay-specific results to guide clinical management. 93,94 The approach follows the principle of equal management of equal risks, meaning that, independent of how a certain risk level is arrived at, the management is the same. Screening, management, and treatment decisions are risk-based, and established clinical decision thresholds are used for the different management steps.…”

Section: Risk-based Management Of Cervical and Anal Precancersmentioning

confidence: 99%

Strategies for screening and early detection of anal cancers: A narrative and systematic review and meta‐analysis of cytology, HPV testing, and other biomarkers

Clarke

Wentzensen

2018

Cancer Cytopathology

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110

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Anal cancer incidence and mortality have been increasing over the past decade. Although the incidence in the general population remains low, it is much higher in certain subgroups, including those living with human immunodeficiency virus and men who have sex with men. Approximately 90% of anal squamous cell cancers are caused by infection with carcinogenic human papillomavirus (HPV). Given the common etiology between anal and cervical carcinogenesis, screening for anal cancer has been proposed in certain high-risk populations using strategies adapted from cervical cancer prevention. In this review, the authors discuss important differences in anal and cervical cancer regarding the populations at risk, disease natural history, and clinical procedures and outcomes that need to be considered when evaluating strategies for anal cancer screening. They also performed a systematic review and meta-analysis of the performance of anal cytology, anal HPV testing, and various biomarkers for the detection of anal precancers and cancers. The implications of these performance estimates are summarized in the context of risk-based screening and management of anal precancers, and important research gaps are highlighted that need to be addressed to fully understand the benefits and harms of anal cancer screening. Cancer Cytopathol 2018. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

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“…New cancer prevention strategies also require knowledge about which cancer detection tests, alone or in combination with primary prevention strategies such as vaccines, are best utilized at which age and how to follow up abnormal test results based on an individual person's risk. Cervical cancer prevention has been a paradigm in this respect [7,8].In addition to morphology, diagnostic pathology reports now comprise multiple types of information, such as mRNA expression and genomic DNA data, as well as histology and immunohistochemical results [9]. Molecular testing has added complexity to cancer diagnosis and care by expanding the number of distinct cancer subtypes (e.g., >150 for hematopoietic neoplasms) that can be identified by specific abnormalities and facilitating selection of precision oncology therapies that target those abnormalities in a patient's cancer.…”

mentioning

confidence: 99%

Improving Cancer Diagnosis and Care: Patient Access to High-Quality Oncologic Pathology

et al. 2019

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Preparing for the Next Round of ASCCP-Sponsored Cervical Screening and Management Guidelines

Cited by 26 publications

References 11 publications

Timely follow‐up of positive cancer screening results: A systematic review and recommendations from the PROSPR Consortium

Timely follow‐up of positive cancer screening results: A systematic review and recommendations from the PROSPR Consortium

Strategies for screening and early detection of anal cancers: A narrative and systematic review and meta‐analysis of cytology, HPV testing, and other biomarkers

Improving Cancer Diagnosis and Care: Patient Access to High-Quality Oncologic Pathology

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