Who Guidelines for Screening and Treatment of Precancerous Lesions for Cervical Cancer Prevention - World Health Organization
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Cervical intraepithelial neoplasia (CIN) is a premalignant lesion that may exist at any one of three stages: CIN1, CIN2, or CIN3. If left untreated, CIN2 or CIN3 (collectively referred to as CIN2+) can progress to cervical cancer. Instead of screening and diagnosis by the standard sequence of cytology, colposcopy, biopsy, and histological confirmation of CIN, an alternative method is to use a screen-and-treat approach in which the treatment decision is based on a screening test and treatment is provided soon or, ideally, immediately after a positive screening test. Available screening tests…mehr

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Produktbeschreibung
Cervical intraepithelial neoplasia (CIN) is a premalignant lesion that may exist at any one of three stages: CIN1, CIN2, or CIN3. If left untreated, CIN2 or CIN3 (collectively referred to as CIN2+) can progress to cervical cancer. Instead of screening and diagnosis by the standard sequence of cytology, colposcopy, biopsy, and histological confirmation of CIN, an alternative method is to use a screen-and-treat approach in which the treatment decision is based on a screening test and treatment is provided soon or, ideally, immediately after a positive screening test. Available screening tests include a human papillomavirus (HPV) test, visual inspection with acetic acid (VIA), and cytology (Pap test). Available treatments include cryotherapy, large loop excision of the transformation zone (LEEP/LLETZ), and cold knife conization (CKC). This guideline provides recommendations for strategies for a screen-and-treat program. It builds upon the existing WHO guidelines: Use of cryotherapy for cervical intraepithelial neoplasia (published in 2011) and on the new WHO guidelines for treatment of cervical intraepithelial neoplasia 2/3 and glandular adenocarcinoma in situ (being published concomitantly with these present guidelines). This guideline is intended primarily for policy-makers, managers, program officers, and other professionals in the health sector who have responsibility for choosing strategies for cervical cancer prevention, at country, regional and district levels. For countries where a cervical cancer prevention and control program already exists, these recommendations were developed to assist decision-makers to determine whether to provide a different screening test followed by a different treatment, or to provide a series of tests followed by an adequate treatment. For countries where such a program does not currently exist, these recommendations can be used to determine which screening test and treatment to provide. In addition to the recommendations, a decision-making flowchart is also proposed in Annex 2 to help program managers choose the right strategy based on the specific country or regional context. Once the strategy has been chosen, the appropriate screen-and-treat flowchart for that strategy can be followed. The flowcharts for all strategies are provided in Annex 3 (specifically for women of negative or unknown HIV status), and Annex 4 (for women of HIV-positive status or unknown HIV status in areas with high endemic HIV infection).
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Autorenporträt
World Health Organization is a Specialized Agency of the United Nations, charged to act as the world's directing and coordinating authority on questions of human health. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries, and monitoring and assessing health trends.