Secondary Prevention of Cervical Cancer: ASCO Resource-Stratified Clinical Practice Guideline

Jose Jeronimo,Michael Quinn,Sarah Temin,Jane J Kim,Youlin Qiao,Philip E Castle,Kathleen M Schmeler,Peter Sasieni,Vandana Gupta,Daniel Murokora,Rengaswamy Sankaranarayanan,Silvana Luciani,Twalib Ngoma,Lynette Denny,Surendra S Shastri

doi:10.1097/01.ogx.0000515823.26591.ed

Abstract

(Abstracted from J Global Oncol 2017; DOI:10.1200/JGO.2016.006577) The aim of the guideline was to provide global resource-stratified, evidence-based recommendations on the secondary prevention of cervical cancer, while accounting for wide variations in resource levels and health systems. These are the first cervical cancer screening guidelines that offer recommendations tailored to resource availability in the settings where women live.

Highlights

The purpose of this guideline is to provide expert guidance on secondary prevention with screening for cervical cancer to clinicians, public health authorities, policymakers, and laypersons in all resource settings
A search for new evidence was conducted by ASCO guidelines staff to identify relevant randomized clinical trials, systematic reviews, meta-analyses, and guidelines published since the Cancer Care Ontario (CCO) and WHO guidelines were completed
On the basis of content and methodology assessments, the Expert Panel chose seven guidelines as the evidentiary basis for the guideline recommendations; these guidelines were from the American Cancer Society (ACS)/American Society for Colposcopy and Cervical Pathology (ASCCP)/American Society for Clinical Pathology (ASCP)[24,25]; a second ASCCP-led effort[26]; another US-based multisociety group’s guideline, referred to here as Huh et al[6]; CCO27; a European guideline, referred to as von Karsa et al[5]; and two guidelines from the WHO.[28,29] (Note that at the time of this writing, the US Preventive Services Task Force was updating its guidelines.30) Appendix Table A2 contains links to these guidelines

Summary

Introduction

The purpose of this guideline is to provide expert guidance on secondary prevention with screening for cervical cancer to clinicians, public health authorities, policymakers, and laypersons in all resource settings. There are large disparities regionally and globally in incidence of and mortality resulting from cervical cancer, in part because of disparities in the provision of mass screening and primary prevention. 85% of incident cervical cancers occur in less developed regions ( known as lowand middle-income countries [LMICs]) around the world, representing 12% of women’s cancers in those regions. Eighty-seven percent of deaths resulting from cervical cancer occur in these less-developed regions.[1] Some of the regions in the world with the highest mortality rates include the WHO Southeast Asia and Western Pacific regions, followed by India and Africa.[1] As a result of these disparities, the ASCO Resource-Stratified Guidelines Advisory Group

Objectives

Methods

Results

Conclusion