Cervical cancer screening

Foreword
Introduction
Summary of recommendations
1. Cervical cancer in Australia
2. The rationale for primary HPV screening
3. Terminology
- Introduction
- HPV testing terminology
- Cytology and AMBS 2004 terminology for reporting cervical cytology
- Preparation of cervical screening reports
- Colposcopy terminology
- Histopathology
- Supplement. Sample reports
4. Unsatisfactory cervical screening results
5. Benefits, harms and cost-effectiveness of cervical screening in the renewed NCSP
6. Management of oncogenic HPV test results
- Introduction
- MSAC recommendations
- Oncogenic HPV types not detected
- Oncogenic HPV types 16 and/or 18
- HPV oncogenic types not 16/18
- Self-collected vaginal samples
- Women undergoing exit testing
- Screening in women older than 75
- Discussion
7. Colposcopy
- Introduction
- Colposcopy terminology
- Principles of practice
- History, examination and investigation
- Treatment
- Colposcopy data for the National Cancer Screening Register
- Quality improvement in colposcopy
- Supplement. Colposcopy information for discussion with patient
- Supplement. Colposcopy technologies and documentation
8. Management of discordant colposcopic impression, histopathology and referral LBC prediction
- Background
- Normal colposcopic findings following LBC prediction of LSIL or HSIL
- Type 3 TZ (unsatisfactory) colposcopy following LBC prediction of LSIL or HSIL
- Discussion
9. Management of histologically confirmed low-grade squamous abnormalities
10. Management of histologically confirmed high-grade squamous abnormalities
- Introduction
- Diagnosis of HSIL
- Treatment of HSIL
- Test of Cure after treatment for HSIL (CIN2/3)
- Discussion
11. Management of glandular abnormalities
- Introduction
- Investigation of cytological glandular abnormalities
- Follow-up after excisional treatment for AIS
- Discussion
12. Screening in Aboriginal and Torres Strait Islander women
13. Screening after total hysterectomy
14. Screening in pregnancy
15. Screening in women who experienced early sexual intercourse or victims of sexual abuse
16. Screening in immune-deficient women
17. Screening in DES-exposed women
18. Signs and symptoms of cervical cancer
- Identification and investigation of abnormal bleeding
- Investigations of other symptoms – vaginal discharge and deep dyspareunia
19. Psychosocial care
20. Transition to the renewed National Cervical Screening Program
Appendices
- A. Modelled evaluation of predicted benefits, harms and cost-effectiveness of renewed NCSP in conjunction with recommendations
- B. Guidelines development process
- C. Clinical question list
- D. Technical report
- E. & F. Working party members and contributors
- G. Declarations of interest register
- H. Safety monitoring of the Renewed cervical screening program
- I. Glossary (terms and abbreviations)

Appendix D. Technical report

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National Cervical Screening Program: Guidelines for the management of screen-detected abnormalities, screening in specific populations and investigation of abnormal vaginal bleeding > Appendix D. Technical report

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This Technical Report accompanies the Clinical management guidelines for the prevention of cervical cancer, developed by Cancer Council Australia.

It outlines the guideline development process and methodology, lists the clinical questions, provides all accompanying NHMRC Statement Forms, the detailed technical docuemntation for each question and the risk of bias assessment tools used to assess the included literature as a result of a systematic review.

Contents[edit source]

Guideline Development Process[edit source]

Figure 1. Overview review process

Overview review process

Clinical question list[edit source]

NHMRC Evidence statements forms[edit source]

Systematic review, modelling and literature review reports[edit source]

Management of oncogenic HPV test results - Oncogenic HPV types not 16/18

Colposcopy - Normal colposcopic findings following LBC prediction of LSIL or HSIL

Colposcopy - Type 3 TZ (previously termed ‘unsatisfactory’) colposcopy following LBC prediction of LSIL or HSIL

Management of histologically confirmed low-grade squamous abnormalities[edit source]

Management of histologically confirmed high-grade squamous abnormalities[edit source]

Treatment of HSIL

Test of Cure after treatment for HSIL (CIN2/3)

Management of glandular abnormalities[edit source]

Investigation of cytological glandular abnormalities

Follow-up after excisional treatment for AIS

Screening in Aboriginal and Torres Strait Islander women[edit source]

Screening after total hysterectomy[edit source]

Literature summary and evidence report question 14

Screening in pregnancy[edit source]

Literature summary and evidence report question 13

Screening in women who have experienced early sexual activity or have been victims of sexual abuse[edit source]

Screening in immune-deficient women[edit source]

Screening in DES-exposed women[edit source]

Investigation of abnormal vaginal bleeding[edit source]

Cohort studies (risk factors) risk of bias assessment tool[edit source]

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