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Evidence Supporting the Current Management Guidelines for High-Grade Squamous Intraepithelial Lesion Cytology

Padilla-Paz, Luis A. MD1; Carlson, Jay DO2; Twiggs, Leo B. MD3; Lonky, Neal MD, MPH4; Crum, Christopher P. MD5; Felix, Juan MD6; Hunter, Verda MD7; Krumholz, Burton MD8; Massad, L. Stewart MD9; Benedet, J.L. MD10

Journal of Lower Genital Tract Disease: April 2004 - Volume 8 - Issue 2 - p 139-146

Objective. The study was undertaken to provide consensus guidelines for the management of women with a cytologic interpretation of high-grade squamous intraepithelial lesion (HSIL) on cytologic examination. This review article presents relevant literature supporting the proposed guidelines.

Participants. An independent panel of 121 experts in various aspects of the diagnosis and management of cervical cancer precursors, including representatives from 29 participating professional organizations, federal agencies, national and international health organizations, and others were invited by the American Society for Colposcopy and Cervical Pathology.

Consensus Process. Guidelines for the management of women with HSIL cytologic results were developed through a multistep process. Draft management guidelines were developed by the HSIL working group after formal literature reviews and obtained input from the professional community at large by way of an interactive internet-based bulletin board. At the American Society for Colposcopy and Cervical Pathology Consensus Conference, September 6 through 8, 2001, in Bethesda, Maryland, the guidelines were discussed, revised, and adopted by formal vote.

Conclusions. Evidence-based guidelines have been developed for the management of women with HSIL cytologic results.

Evidence-based management guidelines for high-grade squamous intraepithelial lesion cytology interpretation are presented.

1University of New Mexico, Albuquerque, NM; 2Walter Reed Army Medical Center, Washington, DC; 3University of Miami School of Medicine, Miami, FL; 4Kaiser Permanente, Anaheim, CA; 5Harvard Medical School, Boston, MA; 6LAC-USC Medical Center, Los Angeles, CA; 7ResourceCenter for Gynecologic Oncology, Kansas City, MO; 8Long Island Jewish Medical Center, New Hyde Park, NY; 9Southern Illinois University, Springfield, IL; and 10British Columbia Cancer Agency, Vancouver, British Columbia, Canada

Reprint requests to: Luis A. Padilla-Paz, MD, Division of Gynecologic Oncology, University of New Mexico, 2211 Lomas Boulevard NE, Albuquerque, NM 87122. E-mail:

©2004The American Society for Colposcopy and Cervical Pathology