Abstract
Aims Annual opportunistic screening for cervical carcinoma has been carried out in Germany since 1971. The creation of this S3 guideline meets an important need, outlined in the National Cancer Plan, with regard to screening for cervical cancer, as the guideline aims to provide important information and support for planned organized screening for cervical cancer in Germany. Methods With the financial support of German Cancer Aid, 21 professional societies developed evidence-based statements and recommendations (classified using the GRADE system) for the screening, management and treatment of precancerous conditions of the cervix. Two independent scientific institutes compiled systematic reviews for this guideline. Recommendations The first part of this short summary presents the pathological basis and considers various questions related to screening for cervical cancer. As also reported in earlier reviews, the meta-analysis by Kleijnen Systematic Reviews showed that HPV-based screening offers better protection against invasive cervical cancer compared to cytology-based screening. The authors of this guideline therefore recommend – in accordance with the guideline of the Joint National Committee of Germany (Gemeinsamer Bundesauschuss, G-BA) – that women aged 35 and above should be examined at regular intervals (at least every 3 years) and undergo HPV-based screening. Co-testing can also be carried out. Women between the ages of 20 and 35 should have cytological screening every 2 years.
Highlights
The guideline recommendations for primary prevention were adopted from the updated S3 guideline on HPV vaccination and supplemented by additional information regarding the impact of HPV vaccination on screening
As outlined in the AWMF Guidance Manual [2], this guideline differentiates between three strengths or levels of recommendation, and the respective level of recommendation is reflected by the syntax used in the recommendation (▶ Table 3)
No symbols or letters were used to grade the expert consensus; the respective level of consensus is shown by the syntax used based on the differentiation described in ▶ Table 3
Summary
With the financial support of German Cancer Aid, 21 professional societies developed evidence-based statements and recommendations (classified using the GRADE system) for the screening, management and treatment of precancerous conditions of the cervix. The Oncology Guidelines Program of the Association of Scientific Medical Societies in Germany German Society for Medical Informatics, Biometry and Epidemiology [Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V.], (GMDS) Gynecological Oncology Working Group of the DKG [Arbeitsgemeinschaft für gynäkologische Onkologie der DKG], (AGO) Self-help for Women after Cancer [Frauenselbsthilfe nach Krebs e. V.], (AZÄD)* Cervical Pathology and Colposcopy Working Group of the DGGG [Arbeitsgemeinschaft Zervixpathologie und Kolposkopie der DGGG]* Prevention and Integrative Oncology Working Group of the DKG, Section B [Arbeitsgemeinschaft Prävention und integrative Onkologie (PRIO), DKG Sektion B] HPV Management Forum of the Paul Ehrlich Society for Chemotherapy [HPV-Management-Forum V.] Working Group on Infections and Immunology of the DGGG [Arbeitsgemeinschaft für Infektionen und Infektionsimmunologie der DGGG], (AGII) German Cancer Research Center, (DKFZ). V. [Self-help for Women After Cancer]) was involved in developing the guideline right from the start and attended the consensus conferences where she had voting rights
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