Conduite à tenir devant une femme ayant une cytologie cervico-utérine anormale : actualisation des recommandations INCa après la mise en place du dépistage par le test HPV

IF 0.6 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Gynecologie Obstetrique Fertilite & Senologie Pub Date : 2025-02-01 DOI:10.1016/j.gofs.2024.11.006

Jean-Luc Brun , Christine Bergeron , Gerlinde Averous , Katty Ardaens , Olivier Aynaud , Hortense Baffet , Sylvain Bouquet , Geoffroy Canlorbe , Charlotte Charpentier , Christine Clavel , Béatrix Cochand-Priollet , Monique Courtade , Mélanie Frigenza , Isabelle Garrigue , Jean Gondry , Isabelle Hernandez , Raphaël Hocquemiller , Bernard Huynh , Philippe Judlin , Karine Le Bail-Carval , Xavier Carcopino

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引用次数: 0

Abstract

Objective

To update the recommendations issued by the National Cancer Institute (INCa) on the management of women with abnormal cervical cytology.

Methods

INCa recommendations on the management of women with abnormal cervical cytology were published in 2016. In 2019, the High Authority of Health (HAS) recommends HPV test for cervical cancer screening in women over 30. It was therefore necessary to update the initial management and follow-up of women with a reflex cytology abnormality after a positive HPV test. We used the modified Delphi method. Each decision tree was modified by the 3 members of the organizing committee and then presented to 35 experts over 2 rounds, in order to obtain their agreement in terms of validity and clarity.

Results

This formalized consensus of experts allowed the creation of 17 decision trees instead of 15 previously: 13 on the diagnostic management of abnormal cytology, stratified according to age, and 4 on therapeutic indications in abnormal histology. The median agreement scores were 89% (81–97).

Conclusion

These 17 decision trees respond to the different situations that health professionals may encounter in order to enable them to act, to follow-up or delegate according to their specialties.

查看原文本刊更多论文

[宫颈细胞学异常妇女的管理：实施HPV筛查后INCa建议的更新]。

目的：更新国家癌症研究所（INCa）发布的关于异常宫颈细胞学妇女管理的建议。方法：2016年发表INCa关于宫颈细胞学异常女性的处理建议。2019年，英国卫生高级管理局（HAS）建议对30岁以上女性进行HPV检测，用于宫颈癌筛查。因此，有必要对HPV检测阳性后出现反射细胞学异常的妇女的初始管理和随访进行更新。采用改进的德尔菲法。每个决策树由3名组委会成员进行修改，然后经过2轮提交给35位专家，以获得他们在有效性和清晰度方面的一致意见。结果：专家的正式共识允许创建17个决策树，而不是之前的15个：13个关于异常细胞学的诊断管理，根据年龄分层，4个关于异常组织学的治疗指征。同意得分中位数为89%（81-97）。结论：这17个决策树对卫生专业人员可能遇到的不同情况作出反应，使他们能够根据自己的专业采取行动、跟进或授权。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gynecologie Obstetrique Fertilite & Senologie Medicine-Obstetrics and Gynecology

CiteScore

1.70

自引率

0.00%

发文量

170

期刊介绍： Gynécologie Obstétrique Fertilité & Sénologie est un mensuel scientifique d''information et de formation destiné aux gynécologues, aux obstétriciens, aux sénologues et aux biologistes de la reproduction. La revue, dans ses éditoriaux, articles originaux, mises au point, lettres à la rédaction et autres rubriques, donne une information actualisée ayant trait à l''obstétrique et à la gynécologie et aux différentes spécialités développées à partir de ces deux pôles : médecine de la reproduction, médecine maternelle et fœtale, périnatalité, endocrinologie, chirurgie gynécologique, cancérologie pelvienne, sénologie, sexualité, psychosomatique…