2013年ACOG临床指南140异常宫颈癌筛查结果和宫颈癌前.pdf

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1、TheAmericanCollegeofObstetriciansandGynecologistsWOMEN’SHEALTHCAREPHYSICIANSPRACTICEBULLETINCLINICALMANAGEMENTGUIDELINESFOROBSTETRICIAN–GYNECOLOGISTSNUMBER140,DECEMBER2013(Obmi^`bpMo^`qf`b?riibqfkKrj_bo66)Ab`bj_bo/--5&ManagementofAbnormalCervicalCancerScreen

2、ingTestResultsandCervicalCancerPrecursorsKnowledgeofthenaturalhistory,epidemiology,andbasicscienceofhumanpapillomavirus(HPV)andprecancerouslesionsofthecervixisrapidlyevolving.Guidelineshavebeenrevisedseveraltimesoverthepastdecadetoincorpo-ratenewevidenceandtechnol

3、ogies(1,2).TheAmericanSocietyforColposcopyandCervicalPathology(ASCCP)clinicalmanagementguidelineswererevisedagainin2012(3),andthisPracticeBulletinisadaptedwithpermissionfromtheASCCPpublication2012UpdatedConsensusGuidelinesfortheManagementofAbnormalCervicalCancerSc

4、reeningTestsandCancerPrecursors.Importantchangestotheseguidelinesincludethefollowing:ëAbcfkfkdtebkqlobqrokqlolrqfkbp`obbkfkd^cqboqob^qjbkqloobplirqflklc^_kloj^ifqfbpdfsbkqebilkdboscreeningintervalsrecommendedbytheupdatedAmericanCancerSocietyscreen

5、ingguidelines(4)ëFjmolsfkdfk`lomlo^qflklcEMSqbpqfkdë>mmivfkddrfabifkbpmobsflrpivabsbilmbaclo^alibp`bkqpqlfkafsfar^ip^dba/.å/1vb^opëFkqbdo^qfkdkbta^q^lkofphlcefde*do^abmob`roploibpflkp^ka`^k`boQeb>P@@Må@liibdblc>jbof`^kM^qelildfpqpI

6、ltbo>kldbkfq^iPnr^jlrpQbojfklildvPq^ka^oafw^qflk%I>PQ&Molgb`qob`ljjbkabapq^ka^oafwfkdefpqlm^qelildf`qbojfklildvcloEMS*^ppl`f^qbapnr^jlrpfkqo^bmfqebif^iibpflkp^kaprmbocf`f^iivfks^pfsbpnr^jlrp`^o`fklj^^`olpp^iiiltbo^kldbkfq^iqo^`qpfqbp%5).

7、Thepurposeofthisdocu-mentistopresentthemostrecentrevisionstoguidelinesformanagingabnormalcervicalcancerscreeningtestresults^ka`bosf`^i`^k`bomob`roplop)abp`of_bqebI>PQMolgb`qqbojfklildv)^kamolsfabdrfa^k`blk^mmivfkdqebkbtmanagementguidelineswiththist

8、erminology.Backgroundofsquamouscervicalneoplasiaandnearlyalltypesofcervicalcancer.OnlyasmallfractionofwomeninfectedNaturalHistoryofCervicalwithHPVwillde