[Management of women with abnormal cervical cytology: Update of INCa recommendations after the implementation of HPV screening].

OBJECTIVE

To update the recommendations issued by the National Cancer Institute (INCa) on the management of women with abnormal cervical cytology.

METHODS

INCa recommendations on the management of women with abnormal cervical cytology were published in 2016. In 2019, the High Authority of Health (HAS) recommends HPV test for cervical cancer screening in women over 30. It was therefore necessary to update the initial management and follow-up of women with a reflex cytology abnormality after a positive HPV test. We used the modified Delphi method. Each decision tree was modified by the 3 members of the organizing committee and then presented to 35 experts over 2 rounds, in order to obtain their agreement in terms of validity and clarity.

RESULTS

This formalized consensus of experts allowed the creation of 17 decision trees instead of 15 previously: 13 on the diagnostic management of abnormal cytology, stratified according to age, and 4 on therapeutic indications in abnormal histology. The median agreement scores were 89% (81-97).

CONCLUSION

These 17 decision trees respond to the different situations that health professionals may encounter in order to enable them to act, to follow-up or delegate according to their specialties.