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Showing content from https://pubmed.ncbi.nlm.nih.gov/36162041/ below:

Secondary Prevention of Cervical Cancer: ASCO Resource-Stratified Guideline Update

Review

Affiliations

• ¹ The University of Texas, MD Anderson Cancer Center, Houston, TX.
• ² American Society of Clinical Oncology, Alexandria, VA.
• ³ IARC, Lyon, France.
• ⁴ Harvard University T.H. Chan School of Public Health, Boston, MA.
• ⁵ National Cancer Institute, Bethesda, MD.
• ⁶ V Care Foundation, Mumbai, India.
• ⁷ Regional Cancer Treatment Services, MidCentral District Health Board, Palmerston North, New Zealand.
• ⁸ Centro Javeriano de Oncología, Bogota, Colombia.
• ⁹ Mulago Hospital, Kampala, Uganda.
• ¹⁰ BC Women's Hospital, Vancouver, BC, Canada.
• ¹¹ University of Washington, Seattle, WA.
• ¹² India Institute of Public Health, Hyderabad, India.
• ¹³ Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
• ¹⁴ University of Malaya, Kuala Lumpur, Malaysia.

• PMID: 36162041
• PMCID: PMC9812449
• DOI: 10.1200/GO.22.00217

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Review

Surendra S Shastri et al. JCO Glob Oncol. 2022 Sep.

• ¹ The University of Texas, MD Anderson Cancer Center, Houston, TX.
• ² American Society of Clinical Oncology, Alexandria, VA.
• ³ IARC, Lyon, France.
• ⁴ Harvard University T.H. Chan School of Public Health, Boston, MA.
• ⁵ National Cancer Institute, Bethesda, MD.
• ⁶ V Care Foundation, Mumbai, India.
• ⁷ Regional Cancer Treatment Services, MidCentral District Health Board, Palmerston North, New Zealand.
• ⁸ Centro Javeriano de Oncología, Bogota, Colombia.
• ⁹ Mulago Hospital, Kampala, Uganda.
• ¹⁰ BC Women's Hospital, Vancouver, BC, Canada.
• ¹¹ University of Washington, Seattle, WA.
• ¹² India Institute of Public Health, Hyderabad, India.
• ¹³ Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
• ¹⁴ University of Malaya, Kuala Lumpur, Malaysia.

• PMID: 36162041
• PMCID: PMC9812449
• DOI: 10.1200/GO.22.00217

Item in Clipboard

Purpose: To update resource-stratified, evidence-based recommendations on secondary prevention of cervical cancer globally.

Methods: American Society of Clinical Oncology convened a multidisciplinary, multinational Expert Panel to produce recommendations reflecting four resource-tiered settings. A review of existing guidelines, formal consensus-based process, and modified ADAPTE process to adapt existing guidelines was conducted. Other experts participated in formal consensus.

Results: This guideline update reflects changes in evidence since the previous update. Five existing guidelines were identified and reviewed, and adapted recommendations form the evidence base. Cost-effectiveness analyses provided indirect evidence to inform consensus, which resulted in ≥ 75% agreement.

Recommendations: Human papillomavirus (HPV) DNA testing is recommended in all resource settings; visual inspection with acetic acid may be used in basic settings. Recommended age ranges and frequencies vary by the following setting: maximal: age 25-65 years, every 5 years; enhanced: age 30-65 years, if two consecutive negative tests at 5-year intervals, then every 10 years; limited: age 30-49 years, every 10 years; basic: age 30-49 years, one to three times per lifetime. For basic settings, visual assessment is used to determine treatment eligibility; in other settings, genotyping with cytology or cytology alone is used to determine treatment. For basic settings, treatment is recommended if abnormal triage results are obtained; in other settings, abnormal triage results followed by colposcopy is recommended. For basic settings, treatment options are thermal ablation or loop electrosurgical excision procedure; for other settings, loop electrosurgical excision procedure or ablation is recommended; with a 12-month follow-up in all settings. Women who are HIV-positive should be screened with HPV testing after diagnosis, twice as many times per lifetime as the general population. Screening is recommended at 6 weeks postpartum in basic settings; in other settings, screening is recommended at 6 months. In basic settings without mass screening, infrastructure for HPV testing, diagnosis, and treatment should be developed.Additional information is available at www.asco.org/resource-stratified-guidelines.

PubMed Disclaimer

Surendra S. Shastri This author is a member of the JCO Global Oncology Editorial Board. Journal policy recused the author from having any role in the peer review of this manuscript. Patty E. Gravitt Research Funding: Cepheid (Inst) Dorothy C. Lombe This author is a member of the JCO Global Oncology Editorial Board. Journal policy recused the author from having any role in the peer review of this manuscript. Yin Ling Woo Honoraria: Roche India Research Funding: COPAN (Inst)No other potential conflicts of interest were reported.

Use of VIA versus use…

Use of VIA versus use of VAT. VAT, visual assessment for treatment; VIA,…

Use of VIA versus use of VAT. VAT, visual assessment for treatment; VIA, visual inspection with acetic acid.

Secondary prevention of cervical cancer…

Secondary prevention of cervical cancer for women age 30-49 in basic‐resource settings. HPV,…

Secondary prevention of cervical cancer for women age 30-49 in basic‐resource settings. HPV, human papillomavirus; LEEP, loop electrosurgical excision procedure; VAT, visual assessment for treatment; VIA, visual inspection with acetic acid.

Secondary prevention of cervical cancer…

Secondary prevention of cervical cancer for women age 30-49 in limited‐resource settings. HPV,…

Secondary prevention of cervical cancer for women age 30-49 in limited‐resource settings. HPV, human papillomavirus; LEEP, loop electrosurgical excision procedure; VIA, visual inspection with acetic acid.

Secondary prevention of cervical cancer…

Secondary prevention of cervical cancer for women age 30-65 in enhanced‐resource settings. HPV,…

Secondary prevention of cervical cancer for women age 30-65 in enhanced‐resource settings. HPV, human papillomavirus; LEEP, loop electrosurgical excision procedure; QA, quality assurance.

Secondary prevention of cervical cancer…

Secondary prevention of cervical cancer for women age 30-65 in maximal‐resource settings. HPV,…

Secondary prevention of cervical cancer for women age 30-65 in maximal‐resource settings. HPV, human papillomavirus; LEEP, loop electrosurgical excision procedure; QA, quality assurance.

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