Guia De Colposcopia En Frances

SOGC JOINT CLINICAL PRACTICE GUIDELINE
No. 284, December 2012

Colposcopic Management of Abnormal
Cervical Cytology and Histology
This clinical practice guideline has been prepared
by the Executive Council of the Society of Canadian
Colposcopists and approved by the Society of Obstetricians
and Gynaecologists of Canada/Society of Gynecologic
Oncology of Canada/Society of CanadianColposcopists
Policy and Practice Guidelines Committee, the Executive
and Council of the Society of Gynecologic Oncology of
Canada and the Executive and Council of the Society of
Obstetricians and Gynaecologists of Canada.
PRINCIPAL AUTHOR
James Bentley, MB ChB, Halifax NS
THE EXECUTIVE COUNCIL OF THE
SOCIETY OF CANADIAN COLPOSCOPISTS
James Bentley, MB ChB, Halifax NS
Monique Bertrand, MD,London ON
Lizabeth Brydon, MD, Regina SK
Hélène Gagné, MD, Ottawa ON
Brian Hauck, MD, Calgary AB
Marie-Hélène Mayrand, MD, Montreal QC
Susan McFaul, MD, Ottawa ON
Patti Power, MD, St . John’s NL
Alexandra Schepansky, MD, Edmonton AB
Marina Straszak-Suri, MD, Ottawa ON
SPECIAL CONTRIBUTORS
Terry Colgan, MD, Toronto ON
Laurette Geldenhuys, MD, Halifax NS
Mark Heywood, MD, Vancouver BCRoberta Howlett, PhD, St . Thomas ON
Linda Kapusta, MD, Mississauga ON
Rachel Kupets, MD, Toronto ON

Abstract
Objective: To provide a guideline for managing abnormal cytology
results after screening for cervical cancer, to clarify the appropriate
algorithms for follow-up after treatment, and to promote the best
possible care for women while ensuring efficient use of available
resources .Outcomes: Women with abnormal cytology are at risk of developing
cervical cancer; appropriate triage and treatment will reduce
this risk . This guideline will facilitate implementation of common
standards across Canada, moving away from the current trend of
individual guidelines in each province and territory .
Evidence: Published literature was retrieved through searches of
PubMed or Medline,CINAHL, and The Cochrane Library in October
2008 using appropriate controlled vocabulary (e .g ., colposcopy,
cervical dysplasia) and key words (e .g ., colposcopy management,
CIN, AGC, cervical dysplasia, LEEP, LLETZ, HPV testing, cervical
dysplasia triage) . Results were restricted to systematic reviews,
randomized control trials/controlled clinical trials, and observational
studies .There were no date or language restrictions . Searches were
updated on a regular basis and incorporated in the guideline to July
2012 . Grey (unpublished) literature was identified through searching
the websites of health technology assessment and health technology
assessment-related agencies, clinical practice guideline collections,
and national and international medical specialty societies .Expert opinion from published peer-reviewed literature and
evidence from clinical trials is summarized . Consensus opinion is
outlined when evidence is insufficient .
Values: The quality of the evidence is rated using the criteria described
by the Canadian Task Force on Preventive Health
Care (Table 1) .
Validation: This guideline has been reviewed for accuracy from content
experts incytology, pathology, and cervical screening programs .
Guideline content was also compared with similar documents from
other organizations including the American Society for Colposcopy and
Cervical Pathology, the British Society for Colposcopy and Cervical
Pathology, and the European Cancer Network .

Joan Murphy, MD, Toronto ON
Jill Nation, MD, Calgary AB
Vyta Senikas, MD, Ottawa ON
MichaelShier, MD, Toronto ON
Disclosure statements have been received from all authors .

J Obstet Gynaecol Can 2012;34(12):1188–1202
Key Words: Cervical cytology, cervical cancer, colposcopy,
treatment, follow-up, abnormalities, guidelines

This document reflects emerging clinical and scientific advances on the date issued and is subject to change. The information
should not be construed as...