11 cases of cervical cancer1 when to start screening?2 what should be done during the screening process?3.21 ~ 29 years old women, the best
11 cases of cervical cancer
1 when to start screening?
2 what should be done during the screening process?
3.21 ~ 29 years old women, the best frequency of cervical cytology screening?
4.30 ~ 65 years old women, the best frequency of cervical cytology screening?
5 stop screening age?
The optimal time to stop screening for 6 patients after total hysterectomy?
7 the significance of HPV detection in cervical cancer screening?
8 atypical squamous cell detection and negative results of HPV detection management.
9 atypical squamous cell detection negative and positive results of HPV detection management.
10 HPV vaccine changes, screening should be changed accordingly?
11 should specific populations be recommended for all cervical cancer screening programs?
Three levels of recommendations and summary:
1.LevelA (unity based on scientific evidence)
(1) the age of cervical cancer screening is recommended to start at the age of 21, except for patients with HIV infection, young women under the age of 21 No matter whether there is no sexual life do not need routine screening.
(2) women aged from 21 to 29 years of age are advised to do it only once a year, only for cervical cytology (3). 30 years before the proposal does not recommend screening.
(3) women aged between 30 and 65 were advised to undergo cytological examination every 3 years for HPV testing every 5 years.
(4) screening should not be stopped at the age of 65 if there are no positive results or a history of CIN2 or above.
(5) patients who have undergone hysterectomy and do not have a history of CIN2 or above are advised to stop screening.
(6) there are risk factors for women, recommendations to improve the screening frequency: HIV infected patients; immune function defect of patients; intrauterine exposure to diethylstilbestrol patients;
Prior to CIN2, CIN3 or cervical cancer patients.
2.LevelB (based on limited non uniform evidence)
(1) patients with CIN2, CIN3, or in situ cancer were screened for a period of up to 20 years after treatment.
(2) patients who had undergone hysterectomy and had a history of CIN2 and above were advised to continue their screening for a period of 20 years, including a cytological examination every 3 years.
(3) it is recommended that women over the age of 25 be screened for HPV.
(4) women with atypical squamous cell carcinoma and negative HPV detection are advised to have a cytological examination every 3 years.
(5) cytology was negative in patients over the age of 30, and patients with positive HPV testing could choose one way:
12 months after repeated screening, if the test results for atypical squamous epithelial hyperplasia or higher level, or HPV test is still positive, you need to perform colposcopy. On the contrary, 3 years of cervical cancer screening.
Rapid HPV specific genotype (HPV-16 and HPV-18), if any test results are positive, the need for direct colposcopy, if the test results are negative, you need to be reviewed after 12 months.
3.LevelC (consensus based and expert advice)
Women who have been vaccinated against HPV are advised to do the same routine screening as unvaccinated women.