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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد

Summary of management with extended genotyping when used with co-testing or cytology triage of primary HPV testing for patients undergoing screening and follow-up of low-grade abnormalities

Summary of management with extended genotyping when used with co-testing or cytology triage of primary HPV testing for patients undergoing screening and follow-up of low-grade abnormalities
  Current HPV Current cytology Past results Management
HPV 16/18 16 HSIL N/A* Treatment preferred; colposcopy acceptable
16 ASC-H N/A Treatment or colposcopy
16 NILM, ASC-US, LSIL, AGC, or no cytology N/A Colposcopy
with collection of cytology if not already done
18 HSIL N/A Treatment or colposcopy
18 NILM, ASCUS, LSIL, ASC-H, AGC, or no cytology N/A Colposcopy
with collection of cytology if not already done

HPV 45, 33/58, 31, 52/35/39/68, 51

Untyped or "other" types when 16 and 18 are not present

 45, 33/58, 31, 52/35/39/68, 51 HSIL, ASC-H, AGC N/A Colposcopy¶Δ
45, 33/58, 31, 52/35/39/68, 51 ASC-US or LSIL N/A Colposcopy
Untyped/other ASC-US or LSIL Documented HPV negative screen in past 5 years or colposcopy <CIN2◊ in past year Repeat HPV test in 1 year
Untyped/other ASC-US or LSIL Any history other than above Colposcopy
45, 33/58, 31, 52/35/39/68, 51, or untyped/other NILM Normal§ or colposcopy <CIN2 within past year Repeat HPV test in 1 year
45, 33/58, 31, 52/35/39/68, 51, or untyped/other N/A HPV+ without colposcopy (ie, current test is second consecutive HPV+) Colposcopy
HPV 59/56/66 59/56/66 ASC-H, AGC, or HSIL¥ N/A Colposcopy
59/56/66 NILM, ASC-US, LSIL or no cytology¥ Normal or colposcopy <CIN2 within past 1 year Repeat HPV test in 1 year
59/56/66 N/A HPV+ without colposcopy (ie, current test is second consecutive HPV+) Colposcopy
For patients with a history of high-grade histology or cytology or following treatment, 2019 guidelines should be followed, but for those individuals, colposcopy is recommended for any HPV+ result and for all cytology LSIL or higher (even if HPV negative).

AGC: atypical glandular cells; ASC-H: atypical squamous cells, cannot exclude high-grade intraepithelial lesion; ASC-US: atypical squamous cells of undetermined significance; HPV: human papillomavirus; HSIL: high-grade squamous intraepithelial lesion; LSIL: low-grade squamous intraepithelial lesion; N/A: not applicable; NILM: negative for intraepithelial lesion or malignancy.

* Test result, if obtained, would not affect management.

¶ Endometrial biopsy recommended for an AGC result if risk factors for endometrial cancer are present (eg, age 35 years or older, obesity, irregular bleeding, anovulation) or if atypical endometrial cells are present.

Δ Colposcopy or treatment is acceptable for results of untyped HPV with ASC-H or HSIL cytology.

◊ Cervical intraepithelial neoplasia grade 2 or less severe.

§ Normal screening history per patient or documented in medical record.

¥ Cytology triage is not recommended for primary HPV screening with results positive for HPV59/56/66; this guideline may be used if cytology results are obtained.

Reproduced with permission from: Wolters Kluwer Health, Inc.: Massad LS, Clarke MA, Perkins RB, et al. Applying results of extended genotyping to management of positive cervicovaginal human papillomavirus test results: Enduring guidelines. J Low Genit Tract Dis 2025; 29(2):134-143. Copyright © 2025 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society for Colposcopy and Cervical Pathology. https://journals.lww.com/jlgtd/pages/default.aspx.
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