@article{11a397d6373645118d4a25ecf4baafa4,
title = "2019 ASCCP Risk-Based Management Consensus Guidelines: Methods for Risk Estimation, Recommended Management, and Validation",
abstract = "Objective To manage cervical screening abnormalities, the 2019 ASCCP management consensus guidelines will recommend clinical action on the basis of risk of cervical precancer and cancer. This article details the methods used to estimate risk, to determine the risk-based management, and to validate that the risk-based recommendations are of general use in different settings. Methods Based on 1.5 million patients undergoing triennial cervical screening by cotesting at the Kaiser Permanente Northern California from 2003 to 2017, we estimated risk profiles for different clinical scenarios and combinations of past and current human papillomavirus and cytology test results. We validated the recommended management by comparing with the estimated risks in several external data sources. Results Risk and management tables are presented separately by Egemen et al.1 and Demarco et al.2 Risk-based management derived from the Kaiser Permanente Northern California largely agreed with the management implied from the estimated risks of the other data sources. Conclusions The new risk-based guidelines present management of abnormal cervical screening results. By describing the steps used to develop these guidelines, the methods presented in this article can provide a basis for future extensions of the risk-based guidelines.",
keywords = "HPV, cervix, portability, risk estimation, risk-based management, screening, validation",
author = "Cheung, {Li C.} and Didem Egemen and Xiaojian Chen and Katki, {Hormuzd A.} and Maria Demarco and Wiser, {Amy L.} and Perkins, {Rebecca B.} and Guido, {Richard S.} and Nicolas Wentzensen and Mark Schiffman",
note = "Funding Information: 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD; 2Department of Family Medicine, Oregon Health & Science University, Portland, OR; 3Boston University School of Medicine, Boston, MA; and 4University of Pittsburgh/Magee-Women's Hospital, Pittsburgh, PA, USA Correspondence to: Li C. Cheung, PhD, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Rm 7E612, Bethesda, MD 20892. E-mail: li.cheung@nih.gov The National Cancer Institute (including M.S. and N.W.) has received cervical screening results and reduced or no cost from commercial research partners (Qiagen, Roche, BD, MobileODT, Arbor Vita) for independent evaluations of screening methods and strategies. R.S.G. reports that he was an ASCCP consultant for the guideline and a DSMB consultant for Ikonosys. The other authors have declared they have no conflicts of interest. This study was supported in part by the Intramural Research Program of the US National Institutes of Health/National Cancer Institute (NCI). The NCI scientists independently conducted the analyses and prepared the manuscript; the conclusions do not necessarily reflect the official views of the NCI. The Kaiser Permanente Northern California (KPNC) and NCI-KPNC Persistence and Progression studies have been reapproved yearly by both KPNC and NCI institutional review board committees. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal{\textquoteright}s Web site (www.jlgtd.com). Copyright {\textcopyright} 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the ASCCP. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. DOI: 10.1097/LGT.0000000000000528 Publisher Copyright: {\textcopyright} Lippincott Williams & Wilkins.",
year = "2020",
month = apr,
day = "1",
doi = "10.1097/LGT.0000000000000528",
language = "English (US)",
volume = "24",
pages = "90--101",
journal = "Journal of Lower Genital Tract Disease",
issn = "1089-2591",
publisher = "Lippincott Williams and Wilkins",
number = "2",
}