Journal of Lower Genital Tract Disease最新文献

{"title":"Evaluating the Benefits of Endocervical Curettage in Women Infected With HPV16/18.","authors":"Yusha Chen, Suyu Li, Jiancui Chen, Huifeng Xue, Xiangqin Zheng, Diling Pan","doi":"10.1097/LGT.0000000000000863","DOIUrl":"10.1097/LGT.0000000000000863","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates the effectiveness of endocervical curettage (ECC) in detecting additional high-grade squamous intraepithelial lesions or worse (HSIL+) in women infected with human papillomavirus (HPV) types 16 and 18, which may be missed by biopsy alone.</p><p><strong>Methods: </strong>A retrospective cohort study analyzed the medical records of 4,811 women referred for colposcopy due to HPV16/18 infection from January 2019 to December 2023. Patients underwent both biopsy and ECC. Statistical comparisons of various clinical factors between HSIL+ and low-grade or normal lesions were performed using χ 2 tests and logistic regression analyses, with stratified analysis to determine ECC's additional detection rate under different clinical conditions.</p><p><strong>Results: </strong>Endocervical curettage detected an additional 6.46% of HSIL+ lesions missed by biopsy alone, with the highest rates in women with normal colposcopic impressions (23.1%), those aged 50 or older (12%), type 3 transformation zones (9.5%), and postmenopausal women (11.9%). In contrast, younger women under 30 and those with type 1 or 2 transformation zones had significantly lower detection rates (2.9%). Logistic regression indicated that older age, type 3 transformation zone, higher grade cytological results, and abnormal colposcopic impressions are significant risk factors for HSIL+ detection via ECC ( p < .001).</p><p><strong>Conclusions: </strong>Data from this study indicate that ECC would be beneficial for women over 30 with HPV16/18 infections, particularly those with type 3 transformation zones or normal colposcopy, as it enhances HSIL+ detection. However, it offers minimal benefit for younger women or those with type 1 or 2 transformation zones.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"111-117"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous Intertriginous Langerhans Cell Histiocytosis in Adults: A Case Report and Systematic Review.","authors":"Patricia K Mansfield, Daniel Tinker, Emily Smith, Nicole M Burkemper, Kristin Smith, Aibing Mary Guo","doi":"10.1097/LGT.0000000000000871","DOIUrl":"10.1097/LGT.0000000000000871","url":null,"abstract":"<p><strong>Objective: </strong>Authors characterized all published adult cases of cutaneous, intertriginous Langerhans cell histiocytosis (LCH) to bring this clinical presentation to the attention of clinicians. The authors emphasize the morphology, histopathology, immunohistochemical profiles, and genetic mutations associated with these cases.</p><p><strong>Materials and methods: </strong>A systematic review of the National Center for Biotechnology Information's PubMed was conducted, utilizing the following specific key words to identify all adult LCH patients with cutaneous intertriginous involvement: \"Intertriginous Langerhans,\" \"Vulvar Langerhans,\" \"Genital Langerhans,\" \"Perineal Langerhans,\" \"Perianal Langerhans,\" \"Intergluteal Langerhans,\" \"Inguinal Langerhans,\" \"Axillary Langerhans,\" and \"Inframammary Langerhans.\" Reports were subjected to strict inclusion criteria: case reports, case series, or meta-analyses documenting case(s) of biopsy-proven LCH with cutaneous, intertriginous involvement in adult patients (>18 years of age at the time of diagnosis).</p><p><strong>Results: </strong>This systematic review identified 1 original and 121 published cases of biopsy-proven, cutaneous, intertriginous LCH in adult patients. Morphology commonly included eroded, ulcerated papules and plaques, and rare presentations demonstrated potential mimickers (hidradenitis suppurativa, deep fungal mycosis, condyloma accuminata).</p><p><strong>Conclusions: </strong>This systematic review encompasses the largest compilation of adult cutaneous intertriginous LCH cases in the medical literature to the authors' knowledge to date. This study identifies an important clinical presentation of this rare, commonly pediatric diagnosis; highlights trends among these cases and important clinical mimickers; and serves as a reminder to clinicians to maintain suspicion for LCH in adult populations, particularly in the setting of intertriginous cutaneous involvement.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"195-200"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of LEEP in Treating CIN 2-3 During Pregnancy.","authors":"Yoav Siegler, Jacob Bornstein, Ofer Lavie, Zvi Vaknin, Nir Kugelman, Efraim Siegler","doi":"10.1097/LGT.0000000000000868","DOIUrl":"10.1097/LGT.0000000000000868","url":null,"abstract":"<p><strong>Abstract: </strong>Cervical intraepithelial neoplasia (CIN) 2-3, a premalignant lesion usually treated by Loop Electrosurgical Excision Procedure (LEEP) in nonpregnant women, is addressed differently in pregnant women. Data from 2006 to 2023 on 178 pregnant women with CIN 2-3 were provided by the Israeli Society of Colposcopy. Sixty-seven underwent LEEP within 15 weeks of gestation with only minor complications. Of the 57 continuing pregnancies, 53 (93%) delivered at term, 2 (3.5%) at 34-37 weeks, and 2 (3.5%) experienced missed abortions. One hundred eleven women were followed through pregnancy without LEEP. Of that group, 5 women were lost to follow-up. From 173 women on whom the authors have follow-up data, 9 (5.2%) were finally diagnosed with cervical cancer, 132 women (76.3%) remained CIN 2-3, and 32 women (18.5%) were CIN 1 or normal. Loop Electrosurgical Excision Procedure (LEEP) performed within the first 15 weeks of pregnancy in 67 women was safe. In 5.2% of pregnant women with CIN 2-3, the final diagnosis was invasive cancer.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"131-133"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Mixed-Methods Study Examining Guideline-Concordant Colposcopy Practices Among a National Cohort of US Colposcopists.","authors":"Rebecca B Perkins, Lindsay Fuzzell, Naomi C Brownstein, Holly B Fontenot, Alexandra Michel, Marena Neggers, Paige Lake, Susan T Vadaparampil","doi":"10.1097/LGT.0000000000000876","DOIUrl":"10.1097/LGT.0000000000000876","url":null,"abstract":"<p><strong>Objectives: </strong>The 2017 ASCCP Colposcopy Standards guidelines were designed to maximize the diagnostic yield of colposcopy. However, guideline adoption is often slow, and few studies have examined management of patients undergoing colposcopy.</p><p><strong>Methods: </strong>To elucidate factors associated with utilization of the 2017 ASCCP Colposcopy Standards guidelines for patients undergoing colposcopic cervical biopsy, the authors cross-sectionally surveyed and interviewed physicians and advanced practice providers who perform colposcopy. Clinicians responded to a clinical vignette describing a common colposcopy scenario. Clinicians were asked to describe where they would biopsy and why. Binomial logistic regression models determined factors associated with guideline concordance. Qualitative interviews further explored practice patterns.</p><p><strong>Results: </strong>A total of 671 colposcopists participated from across the United States. A total of 541 (81%) participants reported colposcopy practice concordant with the 2017 ASCCP Colposcopy Standards guidelines. A total of 490 (73%) participants reported that they were using the 2017 ASCCP Colposcopy Standards guidelines. Male colposcopists and those who were internal and family medicine clinicians were less likely to report guideline-concordant management than females and obstetrician-gynecologists. Colposcopists discussed the rationale behind guideline-concordant aspects of care, including taking targeted biopsies and using excisional rather than ablation procedures.</p><p><strong>Conclusions: </strong>Most colposcopists perform biopsies and treatment consistent with the 2017 ASCCP Colposcopy Standards guidelines and understand the rationale behind multiple targeted biopsies.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"161-167"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adalimumab Use in Severe Recalcitrant Vulval Lichen Sclerosus and Vulval Lichen Planus.","authors":"Ashling Courtney, Sarah Rose Adamson, Emma Veysey","doi":"10.1097/LGT.0000000000000862","DOIUrl":"10.1097/LGT.0000000000000862","url":null,"abstract":"<p><strong>Objectives: </strong>This case series aims to evaluate the demographic features, disease characteristics, and treatment outcomes of 8 patients receiving subcutaneous (SC) adalimumab for severe, refractory vulval lichen sclerosus (VLS) and/or vulval lichen planus (VLP). Both conditions are chronic inflammatory dermatoses that significantly impair quality of life, and although first-line treatment typically involves potent to ultrapotent topical corticosteroids, managing severe cases is challenging due to a lack of FDA-approved systemic therapies. Adalimumab, a TNF-α inhibitor, may offer a promising alternative by targeting the inflammatory cytokine implicated in the pathogenesis of both conditions.</p><p><strong>Methods: </strong>Eight patients received SC adalimumab for VLS and/or VLP at a tertiary referral vulvar disorders clinic from September 2020 to June 2024. Among the 8 patients, 4 had VLS/VLP clinical overlap, 2 had VLP, and 2 had VLS. Evaluation included patient-reported outcome measures (PROMs) namely the vulval life quality index (VLQI) and numerical rating scales for itch and pain, and objective clinical severity was assessed by a vulvar dermatologist based on cutaneous signs and architectural features.</p><p><strong>Results: </strong>Adalimumab was well tolerated by 6 of 8 patients who received treatment for at least 9 months. Varying degrees of clinical improvement were observed in cutaneous signs and PROMs, including significant reductions in vulval life quality index scores for 6 patients. Architectural changes remained stable throughout treatment for all patients.</p><p><strong>Conclusion: </strong>This case series indicates that SC adalimumab may be a treatment option for patients with severe, refractory VLS and VLP, as demonstrated by significant improvements in PROMs. The observed clinical benefits suggest that adalimumab targets key inflammatory pathways in these conditions. Controlled trials are necessary to further validate these findings and define adalimumab's role in managing severe refractory VLS and VLP. Future research should also investigate long-term efficacy and safety, as well as potential predictors of treatment response, to optimize care for this challenging patient population.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"190-194"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician Characteristics Associated With Adoption of Updated National Colposcopy Guidelines.","authors":"Lindsay Fuzzell, Naomi C Brownstein, Holly B Fontenot, Paige Lake, Alexandra Michel, Rebecca B Perkins, Susan T Vadaparampil","doi":"10.1097/LGT.0000000000000877","DOIUrl":"10.1097/LGT.0000000000000877","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate adherence to the 2019 ASCCP risk-based management consensus guidelines for management of patients following colpscopic cervical biopsy among US colposcopists.</p><p><strong>Methods: </strong>To elucidate factors associated with utilization of the 2019 guidelines for patients undergoing colposcopic cervical biopsy, the authors cross-sectionally surveyed physicians and advanced practice professionals who perform colposcopy. Clinicians responded to clinical vignettes describing scenarios for which management recommendations differed between 2019 and prior management guidelines. Vignette 1 involved deferral of repeat colposcopy for patients with a low-risk biopsy, HPV, and cytology results. Vignette 2 involved deferral of excisional treatment on a patient with repeated low-grade biopsy results. Binomial logistic regression models determined factors associated with utilization of 2019 guidelines.</p><p><strong>Results: </strong>A total of 670 colposcopists participated from across the United States. For Vignettes 1 and 2, guideline-adherent responses were given by 30.5% and 66.1% of participants, respectively. Colpsocopists practicing in community health centers were more likely to perform guideline-concordant care for Vignettes 1 and 2. Hispanic compared to non-Hispanic colposcopists and Internal or Family medicine compared to OB-GYN colposcopists are less likely to perform guideline-concordant care in Vignette 2. Irrespective of their chosen response, most believed they were guideline-adherent.</p><p><strong>Conclusions: </strong>Many colposcopists may not realize their current management strategies are inconsistent with 2019 guidelines. Tailored education initiatives could address knowledge gaps, maximize patient benefits, and minimize harms.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"153-160"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Risk of HPV-Related Preneoplastic and Neoplastic Vulvar Lesions in Women Living With HIV.","authors":"Alberto Agarossi, Valeria Savasi, Chiara Frangipane, Francesca Parisi, Andrea Agarossi, Mattia Dominoni, Barbara Gardella","doi":"10.1097/LGT.0000000000000864","DOIUrl":"10.1097/LGT.0000000000000864","url":null,"abstract":"<p><strong>Objective: </strong>The authors aimed to investigate the epidemiology of human papilloma virus (HPV)-related preneoplastic and neoplastic vulvar lesions in a large cohort of women living with HIV (WLWH).</p><p><strong>Materials and methods: </strong>The authors retrospectively selected 1,796 WLWH who had a gynecological examination, cervical cytology, high-risk (HR-) HPV test, vulvoscopy, and colposcopy with targeted biopsies when necessary between 1987 and 2020 at 2 Italian institutions. Univariable and multivariable regression analyses were carried out to test the association of the anamnestic and clinical data with the development of precancerous and cancerous lesions.</p><p><strong>Results: </strong>At baseline, 348 (19.4%) of 1,796 WLWH had genital warts, 30 (1.7%) had vulvar high-grade intraepithelial neoplasia (VHSIL), and 2 (0.1%) had squamous cell carcinoma of the vulva. Among 895 WLWH who had more than 1 year of follow-up, the authors found 40 (4.5%) new cases of VHSIL and 7 (0.8%) cases of vulvar cancer. The cumulative incidence of VHSIL and vulvar cancer was respectively 0.56 and 0.10 per 100 person-years. Risk factors independently associated with the development of vulvar HSIL and cancer included history of injection drug use ( p < .01), genital warts at baseline ( p < .001), HR-HPV test positivity at diagnosis ( p < .001), and severe immunodepression (CD4 cell count <200 cells/mL) at diagnosis ( p < .01).</p><p><strong>Conclusions: </strong>WLWH are at high risk of vulvar high-grade intraepithelial neoplasia and cancer, especially those with severe immunodepression. A careful inspection of vulva, perineum and anus, possibly with the aid of colposcopy, should become part of the surveillance protocol of HIV-infected women.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"118-122"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent Guidelines on Anal Cancer Screening: A Systematic Review.","authors":"Andreia Albuquerque, Filipa Fontes","doi":"10.1097/LGT.0000000000000878","DOIUrl":"10.1097/LGT.0000000000000878","url":null,"abstract":"<p><strong>Objectives: </strong>Reports have recently been published on the risk stratification of anal squamous cell carcinoma (SCC) in several populations and the benefits of treating precancerous anal lesions to reduce the risk of progression to anal SCC. These studies have led several societies to publish new recommendations for anal cancer screening. This study systematically reviews anal cancer screening recommendations across different societies and institutes published after the ANCHOR trial.</p><p><strong>Methods: </strong>The authors systematically reviewed society recommendations for anal cancer screening that have been published since July 2022.</p><p><strong>Results: </strong>This study included 6 publications: 3 societies made recommendations only for individuals living with HIV, and 3 made recommendations for other high-risk groups, such as women with vulvar cancer/high-grade squamous intraepithelial lesions (HSILs) and female transplant recipients. Four societies recommended anal cytology, with or without human papillomavirus (HPV) testing, as the first screening method. One society recommended anal cytology, HPV testing, or cotesting as possible options, while 1 suggested HPV type 16 testing. Only 1 society has made recommendations on screening discontinuation. High-resolution anoscopy was recommended during follow-ups for individuals with abnormal results, although the referral threshold varied between societies according to the screening method results. All societies that mentioned anal HSIL treatment recommended it. Four societies expanded their recommendations beyond screening and treatment to include smoking cessation and/or HPV vaccination.</p><p><strong>Conclusions: </strong>Currently, there are several recommendations for anal cancer screening that include target groups, screening methods, treatment, follow-up, and other anal SCC prevention methods.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"180-185"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemostatic Efficacy of TachoSil in Loop Electrosurgical Excisional Procedure: A Prospective Randomized Controlled Study.","authors":"Junhwan Kim, Jeong-Yeol Park","doi":"10.1097/LGT.0000000000000867","DOIUrl":"10.1097/LGT.0000000000000867","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to evaluate the hemostatic efficacy of the fibrin sealant patch (TachoSil) after loop electrosurgical excision (LEEP) and its influence on other complications and quality of life (QoL).</p><p><strong>Materials and methods: </strong>This single-blind, prospective, randomized study involved patients undergoing LEEP with or without TachoSil (1:1) between August 2014 and August 2015 in Asan Medical Center, Korea. Primary outcome measures were bleeding duration and the frequency of additional treatment owing to vaginal bleeding within 2 weeks after LEEP. Secondary outcome measures were vaginal bleeding volume using pictorial blood loss assessment chart (PBAC) score, the amount of vaginal discharge, the frequency of external genitalia, vaginal, and cervical infections within 2 weeks after LEEP, and changes in QoL.</p><p><strong>Results: </strong>Of the 140 patients enrolled, 126 (90.0%) were successfully followed up and analyzed. The median vaginal bleeding duration and frequency of additional treatment owing to vaginal bleeding showed no significant difference in the TachoSil applied and nonapplied groups ( p = .96 and p = .61, respectively). In addition, no significant difference was also observed in vaginal bleeding volume between 2 groups ( p = .64). In subgroup analysis for patients who underwent large LEEP (the longest dimension of ≥2 cm), significant improvement was observed at physical functioning in QoL at 2-3 ( p = .03) and 6 weeks ( p = .03) after LEEP of the TachoSil applied group, compared to the nonapplied group.</p><p><strong>Conclusions: </strong>TachoSil did not demonstrate significant hemostatic efficacy after LEEP. However, TachoSil improved patient recognition on physical function in patients who underwent large LEEP.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"123-130"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying Results of Extended Genotyping to Management of Positive Cervicovaginal Human Papillomavirus Test Results: Enduring Guidelines.","authors":"L Stewart Massad, Megan A Clarke, Rebecca B Perkins, Francisco Garcia, David Chelmow, Li C Cheung, Teresa M Darragh, Didem Egemen, Thomas S Lorey, Ritu Nayar, Morgan Newman, Carolann Risley, Robert A Smith, Nicolas Wentzensen","doi":"10.1097/LGT.0000000000000865","DOIUrl":"10.1097/LGT.0000000000000865","url":null,"abstract":"<p><strong>Objective: </strong>The Enduring Consensus Cervical Cancer Screening and Management Guidelines Committee developed recommendations for the use of extended genotyping results in cervical cancer prevention programs.</p><p><strong>Methods: </strong>Risks of cervical intraepithelial neoplasia grade 3 or worse were calculated using data obtained with the Onclarity HPV Assay from large cohorts. Management recommendations were based on clinical action thresholds developed for the 2019 American Society for Colposcopy and Cervical Pathology Risk-Based Management Consensus Guidelines. Risk estimates were reviewed in relation to clinical action thresholds and used as the basis for draft recommendations. After an open comment period, recommendations were finalized and ratified through a vote by the Consensus Stakeholder Group.</p><p><strong>Results: </strong>Colposcopy is recommended after positive tests for human papillomavirus (HPV) types 16 and 18. For those positive for HPV 45, 33/58, 31, 52, 35/39/68, or 51 but negative for 16 or 18, triage with cytology or dual stain testing is recommended. When screening with primary HPV testing, for patients who test positive for HPV types 56/59/66 and no other carcinogenic types, repeat HPV testing in 1 year is recommended. When screening with cotesting, for those who test positive for HPV types 56/59/66 and no other carcinogenic types, 1-year return is recommended for negative for intraepithelial lesion or malignancy, atypical squamous cells of undetermined significance, and low-grade squamous intraepithelial lesion, and colposcopy is recommended for atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (ASC-H), atypical glandular cells, high-grade squamous intraepithelial lesion, or carcinoma. When patients without prior high-grade cytology (atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion, atypical glandular cells, high-grade squamous intraepithelial lesion, or carcinoma) or histology (cervical intraepithelial neoplasia [CIN]2, CIN3, or adenocarcinoma in situ) are being followed, use of extended genotyping results is acceptable. When high-grade cytology or histology results are present, or when patients are being followed after treatment of CIN2+, management using the 2019 guidelines is recommended.</p><p><strong>Conclusions: </strong>Human papillomavirus extended genotyping can guide clinical management in the setting of a positive HPV test result.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"134-143"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}