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

Overview
Journal J Low Genit Tract Dis
Specialty Gynecology & Obstetrics
Date 2020 Apr 4
PMID 32243308
Citations 66
Authors
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
Affiliations
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Abstract

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.

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