Practice Improvement in Cervical Screening and Management (PICSM)

Abstract

A symposium with the primary goal of identifying strategies to increase the adoption of evidence based consensus guidelines for cervical cancer screening and the management of abnormal cervical cytology and histology in adolescents and young women was held June 19–20, 2009 in Bethesda, MD at the National Institutes of Health (NIH), under the sponsorship of the American Society for Colposcopy and Cervical Pathology (ASCCP) and in partnership with the American Cancer Society (ACS). The 2006 ASCCP Guidelines for the Management of Women with Abnormal Cervical Cytology and Cervical Cancer Precursors were developed at a consensus process comprising 146 experts representing 29 organizations and professional societies who met at the NIH. The guidelines contain special recommendations to manage abnormal adolescent cytology results. These recommendations have subsequently been adopted by ACOG. The guidelines identify adolescents, defined as females under the age of 21 years, as a special population requiring interventions based on evidence recognizing the natural history of abnormal cytology is different in adolescents than adults. Anecdotal reports and clinician surveys verify under usage of the 2002 ACS [1] and 2003 American College of Obstetricians and Gynecologists (ACOG) guidelines [2], on when to initiate screening, and the 2006 ASCCP management guidelines for adolescents [3–5]. PICSM delegates, representing 22 organizations, reviewed the literature on cytologic abnormalities in adolescent and young women to identify where evidence was lacking, assess adherence to existing recommendations; and, based on these findings, addressed strategies to increase guideline usage in adolescents and young women. Consensus recommendations were achieved on key messages that needed to be disseminated and methods to disseminate and implement them were recommended. Supporting information, not available at the time of the symposium, has been added. The following summarizes the 9 presentations.