UM Guidelines

 

	Added to: Clinical Indications

Cervical Cancer and Abnormal Pap Smears

• Indicated when ALL of the following are present:
• Abnormal PAP smear followed by colposcopically directed cervical biopsies
• Cervical cytology or biopsy showing 1 or more of the following:
  • High-grade squamous intraepithelial lesion (HSIL)
  • Atypical glandular cells (AGC)-favor neoplasia
• CIN-1 on cervical biopsy with 1 or more of the following:
  • CIN-1 preceded by HSIL on prior cervical cytology
  • CIN-1 preceded by atypical glandular cells, not cervical cytology
  • CIN-1 persisting for 6 months
• CIN-2, 3 on cervical biopsy

References

1. BlueCross BlueShield of Tennessee network physicians April - June 2011.
2. Nuovo, J., Melnikow, J., Willian, A. R. & Chan B. K. (2000). Treatment outcomes for squamous intraepithelial lesions. International Journal of Gynaecology and Obstetrics, 68 (1), 25-33.
3. Mitchell, M. F., Tortolero-Luna, G., Cook, E., Whittaker, L., Rhodes-Morris, H., Silva, E. (1998). A randomized clinical trial of cryotherapy, laser vaporization, and loop electrosurgical excision for treatment of squamous intraepithelial lesions of the cervix. Obstetrics and Gynecology, 92(5), 737-44.
4. Wright, T. C., Massad, S., Dunton, C. J., Spitzer, M., Wilkinson, E. J., Soloman, D., for the 2006 American Society for Colposcopy and Cervical Pathology – sponsored Consensus Conference. (2007). 2006 Consensus guidelines for the management of women with cervical intraepithelial neoplasia or adenocarcinoma in situ. American Journal of Obstetrics & Gynecology, 197 (4), 340-345. Retrieved January 17, 2008 from http://www.asccp.org/consensus/histological.shtml.
5. Wright, T. C., Massad, S., Dunton, C. J., Spitzer, M., Wilkinson, E. J., Soloman, D., for the 2006 American Society for Colposcopy and Cervical Pathology – sponsored Consensus Conference. (2007). 2006 consensus guidelines for the management of women with abnormal cervical cancer screening tests.  American Journal of Obstetrics & Gynecology, 197 (4), 346-355. Retrieved January 17, 2008 from http://www.asccp.org/consensus/cytological.shtml.