Initial Management of Abnormal Cervical Cytology (Pap Smear) and HPV Testing. Initial Abnormal Cytology Result Algorithm.

[See BEC algorithm and annotations (boxes 2-6)]

[See ASC-US algorithm and annotations (boxes 7-13)]

[See AGC algorithm and annotations (boxes 16-21)]

[See abnormal cervical cytology in adolescents algorithm and annotations (boxes 30-37)]

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Source: Institute for Clinical Systems Improvement (ICSI). Initial management of abnormal cervical cytology (Pap smear) and HPV testing. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2008 October. 32 p. Initial Management of Abnormal Cervical Cytology (Pap Smear) and HPV Testing Initial Abnormal Cytology Result Algorithm A = Annotation Benign endometrial cells (BEC) present. A See BEC algorithm and annotations (boxes 2-6) Exclusions (see Introduction): *Pregnancy Atypical squamous cells of undetermined significance (ASCUS) present. A See ASC-US algorithm and annotations (boxes 7-13) Atypical squamous cells: cannot exclude high-grade squamous intraepithelial lesion (ASC-H) present. A Colposcopy. A Abnormal Cytology results Atypical glandular cells (AGC) present. A See AGC algorithm and annotations (boxes 16-21) Age 21 or older? A Low-grade squamous intraepithelial lesion (LSIL) present. A Colposcopy. A High-grade squamous intraepithelial lesion (HSIL) present. A Colposcopy with endocervical curettage (ECC) or loop electrosurgical excision (LEEP). A Squamous cell carcinoma or other malignant cells present Out of guideline *Refer to GYN or GYN oncology HPV DNA testing positive with normal cytology. A Repeat HPV DNA testing and cytology at 12 months. A Abnormal cervical cytology in adolescents present. A See abnormal cervical cytology in adolescents algorithm and annotations (boxes 30-37) All copyrights are reserved by the Institute for Clinical Systems Improvement, Inc.