World Health Organization Guidelines for treatment of cervical intraepithelial neoplasia 2-3 and screen-and-treat strategies to prevent cervical cancer

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58 Scopus citations

Abstract

Background It is estimated that 1%-2% of women develop cervical intraepithelial neoplasia grade 2-3 (CIN 2-3) annually worldwide. The prevalence among women living with HIV is higher, at 10%. If left untreated, CIN 2-3 can progress to cervical cancer. WHO has previously published guidelines for strategies to screen and treat precancerous cervical lesions and for treatment of histologically confirmed CIN 2-3. Methods Guidelines were developed using the WHO Handbook for Guideline Development and the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach. A multidisciplinary guideline panel was created. Systematic reviews of randomized controlled trials and observational studies were conducted. Evidence tables and Evidence to Recommendations Tables were prepared and presented to the panel. Results There are nine recommendations for screen-and-treat strategies to prevent cervical cancer, including the HPV test, cytology, and visual inspection with acetic acid. There are seven for treatment of CIN with cryotherapy, loop electrosurgical excision procedure, and cold knife conization. Conclusion Recommendations have been produced on the basis of the best available evidence. However, high-quality evidence was not available. Such evidence is needed, in particular for screen-and-treat strategies that are relevant to low- and middle-income countries.

Original languageEnglish (US)
Pages (from-to)252-258
Number of pages7
JournalInternational Journal of Gynecology and Obstetrics
Volume132
Issue number3
DOIs
Publication statusPublished - Mar 1 2016

Keywords

  • Cervical cancer
  • Cervical intraepithelial neoplasia
  • Guidelines
  • Recommendations
  • Screen
  • Treat

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

World Health Organization Guidelines for treatment of cervical intraepithelial neoplasia 2-3 and screen-and-treat strategies to prevent cervical cancer. / Santesso, Nancy; Mustafa, Reem A.; Schünemann, Holger J.; Arbyn, Marc; Blumenthal, Paul D.; Cain, Joanna; Chirenje, Michael; Denny, Lynette; De Vuyst, Hugo; Eckert, Linda O Neal; Forhan, Sara E.; Franco, Eduardo L.; Gage, Julia C.; Garcia, Francisco A; Herrero, Rolando; Jeronimo, José; Lu, Enriquito R.; Luciani, Silvana; Quek, Swee Chong; Sankaranarayanan, Rengaswamy; Tsu, Vivien; Broutet, Nathalie.

In: International Journal of Gynecology and Obstetrics, Vol. 132, No. 3, 01.03.2016, p. 252-258.

Research output: Contribution to journalArticle