ASCCP Colposcopy Standards: Colposcopy Quality Improvement Recommendations for the United States

Abstract

Objectives The ASCCP Colposcopy Standards recommendations address the role of and approach to colposcopy and biopsy for cervical cancer prevention in the United States. The recommendations were developed by an expert working group appointed by ASCCP’s Board of Directors. The ASCCP Quality Improvement Working Group developed evidence based guidelines to promote best practices and reduce errors in colposcopy and recommended indicators to measure colposcopy quality. Methods The working group performed a systematic review of existing major society and national guidelines and quality indicators. An initial list of potential quality indicators was developed and refined through successive iterative discussions and draft quality indicators were proposed. The draft recommendations were then reviewed and commented on by the entire Colposcopy Standards Committee, posted online for public comment, and presented at the IFCPC 2017 World Congress for further comment. All comments were considered, additional adjustments made, and the final recommendations approved by the entire Task Force. Results Eleven quality indicators were selected spanning documentation, biopsy protocols, and time intervals between index screening tests and completion of diagnostic evaluation. Conclusions The proposed quality indicators are intended to serve as a starting point for quality improvement in colposcopy at a time when colposcopy volume is decreasing and individual procedures are becoming technically more difficult to perform.

Gaps in the screening process for women diagnosed with cervical cancer in four diverse US health care settings

“… 30 , 31 , 32 , 33 New studies have supported enhanced biopsy practice (e.g., random four‐quadrant biopsies) to improve detection, 34 , 35 especially for adenocarcinoma. 36 The development of prediction models may help optimize the use of endocervical curettage in clinical practice. Accelerating the uptake of latest practice guidelines and validated new tools/technology by community‐based practices will be critical to further reduce the incidence of cervical cancer.…”

“…Beyond screening uptake, new techniques such as dual stain and methylation may help risk stratify patients with abnormal screening results to colposcopy and biopsy 30–33 . New studies have supported enhanced biopsy practice (e.g., random four‐quadrant biopsies) to improve detection, 34,35 especially for adenocarcinoma 36 . The development of prediction models may help optimize the use of endocervical curettage in clinical practice.…”

Factores que afectan la suficiencia e interpretación de la citología de cuello uterino

“…La Sociedad Americana de Colposcopia y Patología Cervical recomendó que la citología de cuello uterino en mujeres con resultados insatisfactorios debe repetirse en dos a cuatro meses. 17 Esto podría evitar la interpretación errónea de frotis normales. Si las mujeres presentan síntomas (sangrado genital o flujo vaginal anormal) al momento de la toma de la muestra, el riesgo de resultados anormales de la citología de cuello uterino es cerca de once veces mayor comparado con las mujeres asintomáticas.…”

Application of EfficientNet‐B0 and GRU‐based deep learning on classifying the colposcopy diagnosis of precancerous cervical lesions

“…It is acknowledged as the essential procedure for both the screening and the diagnosis of cervical lesions. Colposcopy and simultaneous cervical biopsy are the gold standards for cervical lesions diagnosis 5 . In daily practice, women who have abnormal cytology reports or high‐risk HPV infection in screening tests should take further colposcopy examinations 5,6 .…”

“…Colposcopy and simultaneous cervical biopsy are the gold standards for cervical lesions diagnosis. 5 In daily practice, women who have abnormal cytology reports or high‐risk HPV infection in screening tests should take further colposcopy examinations. 5 , 6 With the help of colposcopy equipment, the gynecologists observe the cervix at a magnification of 5 to 40 times.…”