2023 Canadian Colposcopy Guideline: A Risk-Based Approach to Management and Surveillance of Cervical Dysplasia

Author:

Willows Karla1,Selk Amanda23ORCID,Auclair Marie-Hélène4ORCID,Jim Brent5,Jumah Naana36,Nation Jill7,Proctor Lily8,Iazzi Melissa9,Bentley James1ORCID

Affiliation:

1. Nova Scotia Cancer Centre, Division of Gynecologic Oncology, Dalhousie University, Halifax, NS B3H 4R2, Canada

2. Women’s College Hospital, Toronto, ON M5S 1B2, Canada

3. Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON M5S, Canada

4. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Hôpital Maisonneuve-Rosemont, CIUSSS de l’Est de l’Île de Montréal, Montréal, QC H1T 2M4, Canada

5. Division of Gynecologic Oncology, Allan Blair Cancer Centre, University of Saskatchewan, Regina, SK S7N 5A2, Canada

6. Department of Obstetrics and Gynecology, Northern Ontario School of Medicine, Thunder Bay, ON P7B 5E1, Canada

7. Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada

8. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada

9. The Society of Gynecologic Oncology of Canada (GOC), Ottawa, ON K1H 8K3, Canada

Abstract

This guideline provides evidence-based guidance on the risk-based management of cervical dysplasia in the colposcopy setting in the context of primary HPV-based screening and HPV testing in colposcopy. Colposcopy management of special populations is also discussed. The guideline was developed by a working group in collaboration with the Gynecologic Oncology Society of Canada (GOC), Society of Colposcopists of Canada (SCC) and the Canadian Partnership Against Cancer (CPAC). The literature informing these guidelines was obtained through a systematic review of the relevant literature via a multi-step search process led by information specialists. The literature was reviewed up to June 2021 with manual searches of relevant national guidelines and more recent publications. Quality of the evidence and strength of recommendations was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. The intended users of this guideline include gynecologists, colposcopists, screening programs and healthcare facilities. Implementation of the recommendations is intended to promote equitable and standardized care for all people undergoing colposcopy in Canada. The risk-based approach aims to improve personalized care and reduce over-/under-treatment in colposcopy.

Funder

Canadian Partnership Against Cancer Corporation and Health Canada

Publisher

MDPI AG

Reference122 articles.

1. (2021). Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem, World Health Organization. Available online: www.wipo.int/amc/en/mediation/rules/.

2. Brenner, D. (2021). Canadian Cancer Statistics Advisory Committee in Collaboration with the Canadian Cancer Society, Statistics Canada and the Public Health Agency of Canada. “Canadian Cancer Statistics 2021”, Canadian Cancer Society.

3. (2022, November 04). Action Plan for the Elimination of cervical cancer in Canada 2020–2030. Available online: https://www.partnershipagainstcancer.ca/topics/elimination-cervical-cancer-action-plan/.

4. Canadian Guideline on the Management of a Positive Human Papillomavirus Test and Guidance for Specific Populations;Zigras;Curr. Oncol.,2023

5. 2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors;Perkins;J. Low. Genit. Tract Dis.,2020

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