Age onset and frequency of screening Cervical cancer screening should begin 3 years after the onset of sexual intercourse, and screening should begin at age 2l at the latest. For women aged ≥70 years. If the cervical structure is intact and the results of at least 3 consecutive formal cytologic examinations within 10 years are not abnormal. or with severe disease, termination of screening may be considered. However, screening is still recommended for women who have not been previously screened or for women for whom records of previous screening are not available, or for whom previous screening is unreliable; screening should be extended for as long as possible if there is a history of previous cervical cancer or CIN, a history of intrauterine application of hexestrol, or the presence of an immunodeficiency status [e.g., human immunodeficiency virus (HIV) infection]. If cervical cytology smears are used for screening. Screening should be done annually or every 2 years if screening is performed using liquid-based cytology. Women ≥30 years of age may be screened every 2-3 years if no abnormality has been detected on 3 consecutive formal screenings (except for those with a history of cervical cancer or CIN, a history of intrauterine application of hexestrol, or an immunodeficiency status. Except for those with HIV infection, for example). Screening using cytology combined with high-risk HPV testing may be repeated at least 3 years later when no abnormalities are found in either. For women who have received HPV vaccine, screening is performed in the same way as for unvaccinated individuals. Cytology and high-risk HPV testing Treatment options including colposcopy or l 6/18 HPV testing are available when cytology results are unremarkable at age ≥30 years and high-risk HPv is positive. When HPV type 16 and 18 test results are positive, colposcopy is performed; if the results are negative, cytology and high-risk HPV testing are repeated after 1 year. If the cytology result is abnormal after 1 year, regardless of the HPV test result, follow-up treatment will be performed according to the treatment of the corresponding abnormal cytology result. If the HPV test is positive and the cytology is not abnormal, colposcopy should be performed. If no abnormalities are found in both, screening can be repeated after 3 years. I. Screening method for women ≤21 years old Women aged ≤21 years old are grouped separately. In case of abnormal cytological findings, the treatment is as follows: ①Atypical squamous cells (Asc-us) are treated in the same way as low-grade squamous intraepithelial neoplasia (LsIL) and ASC-H in the same way as (HSIL). ② High-risk HPV testing was not used. This classification is because HPV infection is very common in women in this age group. and the likelihood of auto-recovery of LsIL is high. Therefore. This group of women is not screened with high-risk HPV testing and is treated differently than older women with LsIL. The reason for this is that studies have shown a high recovery rate of LSIL in this population, and even if CIN III occurs in a few women, the likelihood of the lesion progressing to cancer before the age of 2l is low, and subsequent screening will mostly detect these CIN III patients. Therefore. For women ≤2l years of age. If ASC-US or Dai IL is present cytology can be repeated after 1 year, while colposcopy is required for those aged >2l y. If the results are abnormal after 1 year, colposcopy is performed and routine screening is performed if there is no abnormality. Colposcopy is required if the cytology result is ASC-H or HSIL. II. Screening methods for women >2l years of age Unlike women aged ≤2l years, the same treatment is given for women aged >2l years with cytologic findings of ASC-H, LSL and HSIL, while ASC.US is grouped separately. There are three alternative treatments for ASC-US: high-risk HPV testing, cytology in six months, or colposcopy. If high-risk HPv testing can be performed in the residual fluid of the liquid-based cytology specimen at the same time, this method may be preferred. As this method has the highest cost effectiveness ratio. The sensitivity of detecting CIN II and above lesions is up to 92.5%. The sensitivity of detecting CIN III and above lesions is 95.6%, which is the same as the sensitivity of colposcopy for detecting CIN III. A positive test for high-risk HPV is required. Colposcopy is required. If you choose to repeat the cytologic examination again in six months. If the test result is not abnormal. Repeat the test once more after six months and start routine screening if both results are abnormal. Colposcopy should be performed for any 1 abnormal result. If the cytology result is ASC-H, LSIL and HSIL. Since other methods such as high-risk HPv testing and repeat cytology do not detect lesions as well as colposcopy, colposcopy is used as the only management modality. Colposcopy, management of CIN and follow-up methods One of the features of the NCCN guidelines is that all follow-up management of colposcopy is categorized according to satisfactory or unsatisfactory results and that observation with colposcopy requires the use of 4% glacial acetic acid. This causes the cervical cervix to show a chromogenic reaction. By observing the color and vascular pattern of the cervical area after the application of acetic acid. The nature and extent of the lesion is judged, and satisfaction is evaluated by the complete visualization of the cervical transformation zone. Follow-up colposcopy is done by: ① High-risk HPvDNA testing is still not used for women aged ≤2l years. (When colposcopy is unsatisfactory, endocervical curettage (ECC) is required to clarify the cervical canal as the transformation zone cannot be properly evaluated, and if lesions are found by ECC, LEEP or cold knife conization (CKC) is performed to further clarify the extent of lesions. (iii) Cytological findings have an impact on the choice of physical therapy such as laser cautery or cryotherapy. (When multiple colposcopy is satisfactory, LEEP, CKC, laser cautery or cryotherapy is feasible for women aged >2l years, regardless of cytological examination, when CIN II or CIN III is present, and for CIN III if the pathological diagnosis is clear. Total hysterectomy can also be considered on the basis of adequate communication with the patient. It is recommended to perform cervical electric loop circumcision (I orthoEP) or CKC before hysterectomy to prevent missing infiltrating cancer.