Overview

This WHO and HRP guideline is designed to help countries make faster progress, more equitably, on the screening and treatment of cervical cancer. It includes some important shifts in WHO’s recommended approaches to cervical screening, and includes a total of 23 recommendations and 7 good practice statements.

• Among the 23 recommendations, 6 are identical for both the general population of women and for women living with HIV and 12 are different and specific for each population.
• Among the 7 good practice statements, 3 are identical for both the general population of women and for women living with HIV and 2 are different and specific for each population.

Contents

• Acknowledgements
• Acronyms and abbreviations
• Executive summary
• 1. Introduction
  • 1.1. Background
  • 1.2. Approaches to screening and treatment
  • 1.3. Rationale for this new edition of recommendations
  • 1.4. Phased approach for the development of the recommendations
  • 1.5. Target audience
• 2. Methods
  • 2.1. Groups contributing to the guideline development process
  • 2.2. Scoping review and appraisal of the existing recommendations
  • 2.3. Priority questions for review of evidence
  • 2.4. Priority algorithms
  • 2.5. Outcomes
  • 2.6. Syntheses of evidence
  • 2.7. Development of the recommendations
  • 2.8. Management of the external peer review
• 3. Important considerations for the recommendations
  • 3.1. Programme considerations
  • 3.2. Screening and triage tests considered in this guideline
  • 3.3. Treatment considerations
• 4. Recommendations and good practice statements on screening and treatment to prevent cervical cancer
  • 4.1. Recommendations and good practice statements: general population of women
  • 4.2. Recommendations and good practice statements: women living with HIV
  • 4.3. Additional recommendation and good practice statement for treatment not covered in previous guidelines for the general population of women and women living with HIV
• 5. Research gaps and further considerations
  • Selection of one strategy over another (PICOs 1 and 2)
  • Different duration of follow-up with the same or a different screening test (PICO 3–7)
  • Age at first screening, and minimum number of lifetime screenings (PICO 8i and 8ii)
  • Timing of treatment after positive screening or diagnosis (PICO 9 and 10)
• 6. Dissemination and updating of the guideline
  • 6.1. Guideline dissemination and impact
  • 6.2. Guideline update
• References
• ANNEXES
  • ANNEX 1. GUIDELINE GROUPS
  • ANNEX 2. EVIDENCE-GATHERING TEAMS AND GUIDELINE TASK GROUPS
  • ANNEX 3. DECLARATIONS OF INTERESTS
  • ANNEX 4. SEVEN ALGORITHMS PRIORITIZED FOR PHASE 1 OF THE GUIDELINE UPDATE
  • ANNEX 5. STANDARDIZED DEFINITIONS USED IN THIS GUIDELINE
  • ANNEX 6. ADDITIONAL INFORMATION FOR SCREENING AND TREATMENT RECOMMENDATIONS
• Web Annex A. Syntheses of evidence
• Web Annex B. Evidence to Decision Tables

Suggested citation:

WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention, second edition. Geneva: World Health Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO.

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