Clinical Management / Natural History of Cervical Dysplasia (CIN) and Related Findings

1/2/02


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Table of Contents

Clinical Management / Natural History of Cervical Dysplasia (CIN) and Related Findings

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NORMAL AND NEOPLASTIC CELLULAR CHANGES WITHIN THE TRANSFORMATION ZONE

CERVICAL INTRAEPITHELIAL NEOPLASIA (CIN):

The Bethesda 2001 System

Bethesda 2001 Cervical Cytology Classification

Bethesda 2001 Cervical Cytology Classification

COMPARISON OF THE WHO AND BETHESDA SYSTEM TERMINOLOGY

CAUSES OF NON-CORRELATION BETWEEN CYTOLOGY AND COLPOSCOPY

Specimen Adequacy

Other Non-Neoplastic Findings Optional to report; list not inclusive

Other

Atypical Squamous Cells (ASC)

ASC frequency and association with CIN

Sensitivity of a single repeat Pap test for detection of CIN 2 or CIN 3

ALTS: ASCUS Cytology Review

Ancillary Testing

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HPV Testing vs. Cervical Cytology / ASCUS and above

HPV Testing or Reflex to Colposcopy

Histology and Other Test Results for Women With an ASCUS Pap Test Result* N=973

Management of women with ASCUS (ASC) with HPV testing

Triage test performance of HC 2 and cytology at different thresholds for detection of histologically confirmed CIN3 and CIN2 in the combined human papillomavirus (HPV) triage and immediate colposcopy arms

ASC-H (cannot exclude HSIL): association with CIN 2 or CIN 3

MANAGEMENT OF ASC-H

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MANAGEMENT OF ASC-US

LSIL frequency and association with CIN

FOLLOW-UP: OBSERVATION VS. THERAPY

MANAGEMENT OF LSIL

HSIL frequency and association with CIN

MANAGEMENT OF HSIL

HPV results by HC 2

HIGH RISK HPV DETECTION

Risk of high-grade CIN in relation to time since first exposure to HPV 16

Pap test Results Preceding the Identification of women with CIN 2 or CIN 3

AGC frequency and association with CIN, Adenocarcinoma in situ (AIS) or Cervical or Endometrial Adenocarcinoma

Glandular Cell Abnormalities

Glandular Cell Abnormalities

AGC associated with CIN 2 or CIN 3

Cervical Adenocarcinoma Associated with HPV Types 16 and 18

MANAGEMENT OF AGC

Natural history of mild dysplasia (CIN 1)

Natural history of moderate dysplasia (CIN 2)

Natural history of CIS (CIN 3)

Natural history of CIN: summary

Regression

Progression

Invasive Cancer

MANAGEMENT OF CIN 1

FOLLOW UP FOR CIN 1

FOLLOW-UP: OBSERVATION VS. THERAPY

FOLLOW-UP: OBSERVATION VS. THERAPY

OBSERVATIONAL FOLLOW-UP, CIN 1

TREATMENT VS. OBSERVATION

TREATMENT VS. OBSERVATION

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TREATMENT OUTCOMES FOR CIN

METHODS TO TREAT CIN

RISK OF SIGNIFICANT HEMORRHAGE ASSOCIATED WITH TREATMENT FOR CIN

RESIDUAL CIN AFTER LEEP/CONE

MANAGEMENT OF CIN

CERVICAL CARCINOMA STAGING

Clinical Management / Natural History of Cervical Dysplasia (CIN) and Related Findings

Author: Department of Pathology