Since the publication of the 2001 Consensus Guidelines, new information has become available which includes the key follow-up results from the National Cancer Institute (NCI)-sponsored ASCUS (atypical squamous cells of undetermined significance)/LSIL (low-grade squamous intraepithelial lesion Triage Study (ALTS). Moreover, molecular testing for high-risk types of human papillomavirus (HPV) is being used together with cervical cytology for screening in women 30 years of age and older. Although "interim guidance" for the use of HPV deoxyribonucleic acid (DNA) testing in the screening setting was proposed in 2004 by the American Cancer Society (ACS), NCI, and ASCCP, recommendations for how to manage the combination of test results have not been formally evaluated by a large, multidisciplinary group. Once the guidelines were implemented in a variety of clinical settings and became the standard for management of these clinical problems, it became apparent that there were a number of areas in which changes were needed, particularly in regards to the populations of adolescents and postmenopausal women. Thus in 2005, the American Society for Colposcopy and Cervical Pathology (ASCCP), together with its partner professional societies and Federal and international organizations, began the process of revising the guidelines.

Working Groups composed of representatives of the ASCCP, ACS, NCI, Society of Gynecologic Oncologists (SGO), College of American Pathologists (CAP), American College of Obstetricians and Gynecologists (ACOG), the Centers for Disease Control and Prevention (CDC), and others performed comprehensive literature reviews of various aspects of Papanicolaou test management published after 2000. New Working Groups were also created to evaluate special management algorithms for young women and women with abnormal results of HPV DNA testing.

The Working Groups developed draft guidelines based on a critical evaluation of the published literature. The draft guidelines were made available for two public comment periods in the spring and summer of 2006 through internet-based bulletin boards monitored by the Working Groups and the overall Steering Committee. After each public comment period concluded, the draft guidelines were taken off the internet and revised to reflect the public comments. After the final revision, the guidelines and the comprehensive literature reviews were rated to include an indication of the quality of clinical evidence supporting the specific recommendation and the strength of the recommendation. In additional three separate conference calls of the invited Conference participants to discuss the prospective 'hot topics' were held in the summer of 2006. The invited participants included over 140 selected experts in the fields of gynecological cytology, pathology, and management of cervical disease, all of whom served as appointed delegates of the sponsoring medical organizations and Federal agencies (see below for sponsors' list).

The resulting draft Consensus Guidelines for the management of cervical cytological and histological abnormalities were then presented to the invited participants and formal observers at the ASCCP Consensus Conference, held on September 18-19, 2006, at the Natcher Conference Center on the NIH campus, in Bethesda, Maryland where they were discussed, modified as necessary, and then voted on. Following the Conference, the ASCCP Steering Committee drafted the guidelines and submitted them for publication in the American Journal for Obstetrics and Gynecology and the ASCCP's Journal of Lower Genital Tract Disease.

View the complete listing of Working Groups, Participants, Observers, and Participating Organizations...

The 2006 Consensus Guidelines for the Management of Women with Abnormal Cervical Screening Tests and the Management of Women with Cervical Intraepithelial Neoplasia or Adenocarcinoma in situ were published in the October 2007 issue of the American Journal of Obstetrics and Gynecology. Both the cytology and histology guidelines were also reprinted in the October 2007 issue of the Journal of Lower Genital Tract Disease. Algorithms for the guidelines were published solely in the Journal of Lower Genital Tract Disease.

NOTE: Copyright in the line-by-line text of the 2006 Consensus Guidelines belongs to Elsevier. Copyright in the 2006 Consensus Guidelines algorithms belongs to ASCCP. Permission to reprint guidelines text for any purpose (e.g., educational or commercial) requires sole, exclusive written permission by Elsevier. Permission to reprint the algorithms requires sole, exclusive written permission of ASCCP. Instructions to obtain reprint permission for either the guidelines text or algorithms are posted with the guidelines and algorithms. No adaptations of the algorithms will be permitted, including any proposed changes in formatting (e.g., color, font, or style).