U.S. flag

An official website of the United States government

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

WHO Guidelines for Screening and Treatment of Precancerous Lesions for Cervical Cancer Prevention. Geneva: World Health Organization; 2013.

  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

Cover of WHO Guidelines for Screening and Treatment of Precancerous Lesions for Cervical Cancer Prevention

WHO Guidelines for Screening and Treatment of Precancerous Lesions for Cervical Cancer Prevention.

Show details

Screen-and-treat strategy summary recommendations

These recommendations apply to all women regardless of HIV status, but specific recommendations for women living with HIV have been developed.

The expert panel1 recommends against the use of CKC as a treatment in a screen-and-treat strategy. Therefore, all screen-and-treat strategies below involve treatment with cryotherapy, or LEEP when the patient is not eligible for cryotherapy.

The expert panel suggests:

Use a strategy of screen with an HPV test and treat, over a strategy of screen with VIA and treat. In resource-constrained settings, where screening with an HPV test is not feasible, the panel suggests a strategy of screen with VIA and treat.

Use a strategy of screen with an HPV test and treat, over a strategy of screen with cytology followed by colposcopy (with or without biopsy) and treat. However, in countries where an appropriate/high-quality screening strategy with cytology followed by colposcopy already exists, either an HPV test or cytology followed by colposcopy could be used.

Use a strategy of screen with VIA and treat, over a strategy of screen with cytology followed by colposcopy (with or without biopsy) and treat. The recommendation for VIA over cytology followed by colposcopy can be applied in countries that are currently considering either programme or countries that currently have both programmes available.

Use a strategy of screen with an HPV test and treat, over a strategy of screen with an HPV test followed by colposcopy (with or without biopsy) and treat.

Use either a strategy of screen with an HPV test followed by VIA and treat, or a strategy of screen with an HPV test and treat.

Use a strategy of screen with an HPV test followed by VIA and treat, over a strategy of screen with VIA and treat.

Use a strategy of screen with an HPV test followed by VIA and treat, over a strategy of screen with cytology followed by colposcopy (with or without biopsy) and treat.

Use a strategy of screen with an HPV test followed by VIA and treat, over a strategy of screen with an HPV test followed by colposcopy (with or without biopsy) and treat.

1

The expert panel includes all members of the WHO Steering Group, the Guideline Development Group (GDG), and the External Review Group (ERG)

As shown below, a decision-making flowchart has been developed that will assist programme managers to choose one of the suggested strategies, depending on the context where it will be implemented (also provided in Annex 2). Details about the flow of each different strategy are also presented in the flowcharts in Annex 3 (for women of negative or unknown HIV status) and Annex 4 (for women of HIV-positive status or unknown HIV status in areas with high endemic HIV infection).

Flowchart Icon

Decision-making flowchart for programme managers (PDF, 407K)

Copyright © World Health Organization 2013.

All rights reserved. Publications of the World Health Organization are available on the WHO web site (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: tni.ohw@sredrokoob).

Requests for permission to reproduce or translate WHO publications –whether for sale or for non-commercial distribution– should be addressed to WHO Press through the WHO web site (www.who.int/about/licensing/copyright_form/en/index.html).

Bookshelf ID: NBK195235

Views

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...