Management of abnormal cervical cytology

  With the popularity of cervical cancer screening, abnormalities in cytology are increasingly detected, which makes many patients nervous and even fearful, and they often ask me worriedly, “Dr. Chen, do I have cervical cancer?” In fact, cytology screening is mainly for screening out women with possible cervical precancer in the population, and there is a set of standard for the diagnosis and management of cervical precancer.  The most commonly used cervical cancer screening tests are cervical cytology (TCT/CCT/LCT) and HPV testing. Some of the 2012 American Society for Colposcopy and Cervical Pathology (ASCCP) treatment guidelines are now briefly described.  If the cervical cytology test (TCT/CCT/LCT) is reported as atypical squamous epithelial cells of uncertain significance (ASC-US), then the following options are available to everyone: 1. HPV testing is preferred (for women ≥30 years of age). If HPV is positive, colposcopy will be performed; if negative, TCT and HPV will be repeated in 3 years. 2. It is also optional to repeat TCT after 12 months, especially in women aged 21-24 years. If the TCT is still abnormal after the review, colposcopy will be performed; if it is negative, TCT will be repeated after 3 years. 3. Direct colposcopy is not recommended.