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Jeronimo J, Castle PE, Temin S, Denny L, Gupta V, Kim JJ, Luciani S, Murokora D, Ngoma T, Qiao Y, Quinn M, Sankaranarayanan R, Sasieni P, Schmeler KM, Shastri SS. Secondary Prevention of Cervical Cancer: ASCO Resource-Stratified Clinical Practice Guideline. J Glob Oncol 2017; 3:635-657. [PMID: 29094101 PMCID: PMC5646891 DOI: 10.1200/jgo.2016.006577] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To provide resource-stratified, evidence-based recommendations on the secondary prevention of cervical cancer globally. METHODS ASCO convened a multidisciplinary, multinational panel of oncology, primary care, epidemiology, health economic, cancer control, public health, and patient advocacy experts to produce recommendations reflecting four resource-tiered settings. A review of existing guidelines, a formal consensus-based process, and a modified ADAPTE process to adapt existing guidelines were conducted. Other experts participated in formal consensus. RESULTS Seven existing guidelines were identified and reviewed, and adapted recommendations form the evidence base. Four systematic reviews plus cost-effectiveness analyses provided indirect evidence to inform consensus, which resulted in ≥ 75% agreement. RECOMMENDATIONS Human papillomavirus (HPV) DNA testing is recommended in all resource settings; visual inspection with acetic acid may be used in basic settings. Recommended age ranges and frequencies by setting are as follows: maximal: ages 25 to 65, every 5 years; enhanced: ages 30 to 65, if two consecutive negative tests at 5-year intervals, then every 10 years; limited: ages 30 to 49, every 10 years; and basic: ages 30 to 49, one to three times per lifetime. For basic settings, visual assessment is recommended as triage; in other settings, genotyping and/or cytology are recommended. For basic settings, treatment is recommended if abnormal triage results are present; in other settings, colposcopy is recommended for abnormal triage results. For basic settings, treatment options are cryotherapy or loop electrosurgical excision procedure; for other settings, loop electrosurgical excision procedure (or ablation) is recommended. Twelve-month post-treatment follow-up is recommended in all settings. Women who are HIV positive should be screened with HPV testing after diagnosis and screened twice as many times per lifetime as the general population. Screening is recommended at 6 weeks postpartum in basic settings; in other settings, screening is recommended at 6 months. In basic settings without mass screening, infrastructure for HPV testing, diagnosis, and treatment should be developed.Additional information can be found at www.asco.org/rs-cervical-cancer-secondary-prev-guideline and www.asco.org/guidelineswiki.It is the view of of ASCO that health care providers and health care system decision makers should be guided by the recommendations for the highest stratum of resources available. The guideline is intended to complement, but not replace, local guidelines.
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Affiliation(s)
- Jose Jeronimo
- , PATH, Seattle, WA; , Global Coalition Against Cervical Cancer, Albert Einstein College of Medicine, Arlington; , American Society of Clinical Oncology, Alexandria, VA; , University of Cape Town, Cape Town, South Africa; , V Care; , Tata Memorial Center, Mumbai, India; , Harvard T.H. Chan School of Public Health, Boston, MA; , PanAmerican Health Organization, Washington, DC; , Uganda Women's Health Initiative, Kampala, Uganda; , International Network for Cancer Treatment and Research, Dar Es Salaam, Tanzania; , Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; , University of Melbourne, Melbourne, Victoria, Australia; , International Agency for Research on Cancer, Lyon, France; , Queen Mary, University of London, London, United Kingdom; and , The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Philip E Castle
- , PATH, Seattle, WA; , Global Coalition Against Cervical Cancer, Albert Einstein College of Medicine, Arlington; , American Society of Clinical Oncology, Alexandria, VA; , University of Cape Town, Cape Town, South Africa; , V Care; , Tata Memorial Center, Mumbai, India; , Harvard T.H. Chan School of Public Health, Boston, MA; , PanAmerican Health Organization, Washington, DC; , Uganda Women's Health Initiative, Kampala, Uganda; , International Network for Cancer Treatment and Research, Dar Es Salaam, Tanzania; , Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; , University of Melbourne, Melbourne, Victoria, Australia; , International Agency for Research on Cancer, Lyon, France; , Queen Mary, University of London, London, United Kingdom; and , The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sarah Temin
- , PATH, Seattle, WA; , Global Coalition Against Cervical Cancer, Albert Einstein College of Medicine, Arlington; , American Society of Clinical Oncology, Alexandria, VA; , University of Cape Town, Cape Town, South Africa; , V Care; , Tata Memorial Center, Mumbai, India; , Harvard T.H. Chan School of Public Health, Boston, MA; , PanAmerican Health Organization, Washington, DC; , Uganda Women's Health Initiative, Kampala, Uganda; , International Network for Cancer Treatment and Research, Dar Es Salaam, Tanzania; , Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; , University of Melbourne, Melbourne, Victoria, Australia; , International Agency for Research on Cancer, Lyon, France; , Queen Mary, University of London, London, United Kingdom; and , The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Lynette Denny
- , PATH, Seattle, WA; , Global Coalition Against Cervical Cancer, Albert Einstein College of Medicine, Arlington; , American Society of Clinical Oncology, Alexandria, VA; , University of Cape Town, Cape Town, South Africa; , V Care; , Tata Memorial Center, Mumbai, India; , Harvard T.H. Chan School of Public Health, Boston, MA; , PanAmerican Health Organization, Washington, DC; , Uganda Women's Health Initiative, Kampala, Uganda; , International Network for Cancer Treatment and Research, Dar Es Salaam, Tanzania; , Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; , University of Melbourne, Melbourne, Victoria, Australia; , International Agency for Research on Cancer, Lyon, France; , Queen Mary, University of London, London, United Kingdom; and , The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Vandana Gupta
- , PATH, Seattle, WA; , Global Coalition Against Cervical Cancer, Albert Einstein College of Medicine, Arlington; , American Society of Clinical Oncology, Alexandria, VA; , University of Cape Town, Cape Town, South Africa; , V Care; , Tata Memorial Center, Mumbai, India; , Harvard T.H. Chan School of Public Health, Boston, MA; , PanAmerican Health Organization, Washington, DC; , Uganda Women's Health Initiative, Kampala, Uganda; , International Network for Cancer Treatment and Research, Dar Es Salaam, Tanzania; , Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; , University of Melbourne, Melbourne, Victoria, Australia; , International Agency for Research on Cancer, Lyon, France; , Queen Mary, University of London, London, United Kingdom; and , The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jane J Kim
- , PATH, Seattle, WA; , Global Coalition Against Cervical Cancer, Albert Einstein College of Medicine, Arlington; , American Society of Clinical Oncology, Alexandria, VA; , University of Cape Town, Cape Town, South Africa; , V Care; , Tata Memorial Center, Mumbai, India; , Harvard T.H. Chan School of Public Health, Boston, MA; , PanAmerican Health Organization, Washington, DC; , Uganda Women's Health Initiative, Kampala, Uganda; , International Network for Cancer Treatment and Research, Dar Es Salaam, Tanzania; , Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; , University of Melbourne, Melbourne, Victoria, Australia; , International Agency for Research on Cancer, Lyon, France; , Queen Mary, University of London, London, United Kingdom; and , The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Silvana Luciani
- , PATH, Seattle, WA; , Global Coalition Against Cervical Cancer, Albert Einstein College of Medicine, Arlington; , American Society of Clinical Oncology, Alexandria, VA; , University of Cape Town, Cape Town, South Africa; , V Care; , Tata Memorial Center, Mumbai, India; , Harvard T.H. Chan School of Public Health, Boston, MA; , PanAmerican Health Organization, Washington, DC; , Uganda Women's Health Initiative, Kampala, Uganda; , International Network for Cancer Treatment and Research, Dar Es Salaam, Tanzania; , Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; , University of Melbourne, Melbourne, Victoria, Australia; , International Agency for Research on Cancer, Lyon, France; , Queen Mary, University of London, London, United Kingdom; and , The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Daniel Murokora
- , PATH, Seattle, WA; , Global Coalition Against Cervical Cancer, Albert Einstein College of Medicine, Arlington; , American Society of Clinical Oncology, Alexandria, VA; , University of Cape Town, Cape Town, South Africa; , V Care; , Tata Memorial Center, Mumbai, India; , Harvard T.H. Chan School of Public Health, Boston, MA; , PanAmerican Health Organization, Washington, DC; , Uganda Women's Health Initiative, Kampala, Uganda; , International Network for Cancer Treatment and Research, Dar Es Salaam, Tanzania; , Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; , University of Melbourne, Melbourne, Victoria, Australia; , International Agency for Research on Cancer, Lyon, France; , Queen Mary, University of London, London, United Kingdom; and , The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Twalib Ngoma
- , PATH, Seattle, WA; , Global Coalition Against Cervical Cancer, Albert Einstein College of Medicine, Arlington; , American Society of Clinical Oncology, Alexandria, VA; , University of Cape Town, Cape Town, South Africa; , V Care; , Tata Memorial Center, Mumbai, India; , Harvard T.H. Chan School of Public Health, Boston, MA; , PanAmerican Health Organization, Washington, DC; , Uganda Women's Health Initiative, Kampala, Uganda; , International Network for Cancer Treatment and Research, Dar Es Salaam, Tanzania; , Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; , University of Melbourne, Melbourne, Victoria, Australia; , International Agency for Research on Cancer, Lyon, France; , Queen Mary, University of London, London, United Kingdom; and , The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Youlin Qiao
- , PATH, Seattle, WA; , Global Coalition Against Cervical Cancer, Albert Einstein College of Medicine, Arlington; , American Society of Clinical Oncology, Alexandria, VA; , University of Cape Town, Cape Town, South Africa; , V Care; , Tata Memorial Center, Mumbai, India; , Harvard T.H. Chan School of Public Health, Boston, MA; , PanAmerican Health Organization, Washington, DC; , Uganda Women's Health Initiative, Kampala, Uganda; , International Network for Cancer Treatment and Research, Dar Es Salaam, Tanzania; , Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; , University of Melbourne, Melbourne, Victoria, Australia; , International Agency for Research on Cancer, Lyon, France; , Queen Mary, University of London, London, United Kingdom; and , The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael Quinn
- , PATH, Seattle, WA; , Global Coalition Against Cervical Cancer, Albert Einstein College of Medicine, Arlington; , American Society of Clinical Oncology, Alexandria, VA; , University of Cape Town, Cape Town, South Africa; , V Care; , Tata Memorial Center, Mumbai, India; , Harvard T.H. Chan School of Public Health, Boston, MA; , PanAmerican Health Organization, Washington, DC; , Uganda Women's Health Initiative, Kampala, Uganda; , International Network for Cancer Treatment and Research, Dar Es Salaam, Tanzania; , Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; , University of Melbourne, Melbourne, Victoria, Australia; , International Agency for Research on Cancer, Lyon, France; , Queen Mary, University of London, London, United Kingdom; and , The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Rengaswamy Sankaranarayanan
- , PATH, Seattle, WA; , Global Coalition Against Cervical Cancer, Albert Einstein College of Medicine, Arlington; , American Society of Clinical Oncology, Alexandria, VA; , University of Cape Town, Cape Town, South Africa; , V Care; , Tata Memorial Center, Mumbai, India; , Harvard T.H. Chan School of Public Health, Boston, MA; , PanAmerican Health Organization, Washington, DC; , Uganda Women's Health Initiative, Kampala, Uganda; , International Network for Cancer Treatment and Research, Dar Es Salaam, Tanzania; , Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; , University of Melbourne, Melbourne, Victoria, Australia; , International Agency for Research on Cancer, Lyon, France; , Queen Mary, University of London, London, United Kingdom; and , The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Peter Sasieni
- , PATH, Seattle, WA; , Global Coalition Against Cervical Cancer, Albert Einstein College of Medicine, Arlington; , American Society of Clinical Oncology, Alexandria, VA; , University of Cape Town, Cape Town, South Africa; , V Care; , Tata Memorial Center, Mumbai, India; , Harvard T.H. Chan School of Public Health, Boston, MA; , PanAmerican Health Organization, Washington, DC; , Uganda Women's Health Initiative, Kampala, Uganda; , International Network for Cancer Treatment and Research, Dar Es Salaam, Tanzania; , Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; , University of Melbourne, Melbourne, Victoria, Australia; , International Agency for Research on Cancer, Lyon, France; , Queen Mary, University of London, London, United Kingdom; and , The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Kathleen M Schmeler
- , PATH, Seattle, WA; , Global Coalition Against Cervical Cancer, Albert Einstein College of Medicine, Arlington; , American Society of Clinical Oncology, Alexandria, VA; , University of Cape Town, Cape Town, South Africa; , V Care; , Tata Memorial Center, Mumbai, India; , Harvard T.H. Chan School of Public Health, Boston, MA; , PanAmerican Health Organization, Washington, DC; , Uganda Women's Health Initiative, Kampala, Uganda; , International Network for Cancer Treatment and Research, Dar Es Salaam, Tanzania; , Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; , University of Melbourne, Melbourne, Victoria, Australia; , International Agency for Research on Cancer, Lyon, France; , Queen Mary, University of London, London, United Kingdom; and , The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Surendra S Shastri
- , PATH, Seattle, WA; , Global Coalition Against Cervical Cancer, Albert Einstein College of Medicine, Arlington; , American Society of Clinical Oncology, Alexandria, VA; , University of Cape Town, Cape Town, South Africa; , V Care; , Tata Memorial Center, Mumbai, India; , Harvard T.H. Chan School of Public Health, Boston, MA; , PanAmerican Health Organization, Washington, DC; , Uganda Women's Health Initiative, Kampala, Uganda; , International Network for Cancer Treatment and Research, Dar Es Salaam, Tanzania; , Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; , University of Melbourne, Melbourne, Victoria, Australia; , International Agency for Research on Cancer, Lyon, France; , Queen Mary, University of London, London, United Kingdom; and , The University of Texas MD Anderson Cancer Center, Houston, TX
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