 |
|
Presented by Dr. J. Thomas Cox, MD
Release Date of Activity: December 2009
Expiration Date of Activity for AMA PRA Credit: December 31, 2012
Estimated Time to Complete This Activity: 1 hour
Authors and Reviewers Biosketches |
To register for the Online CME Series click here Course Summary and Competency Goals
The management of women with cervical squamous or glandular intraepithelial neoplasia has changed significantly over the past five decades due to a far greater understanding of the etiology and the natural history of these lesions, as well as a greater appreciation of both the benefits accrued from appropriate treatment and the potential for harm that may result from over-treatment. The 2001 ASCCP Consensus Conference on the Management of Women with Cervical Cytological Abnormalities and Cervical Cancer Precursors provided the first evidence-based guidelines on the management of women with histologic cervical intraepithelial neoplasia grades 1-3 (CIN1-3). The 2006 ASCCP Consensus Guidelines have updated the 2001 recommendations and have added guidelines for the management of women with adenocarcinoma in-situ (AIS). This session discusses the history of the evolution of treatment of cervical cancer precursors in the context of expanding knowledge on the role of human papillomavirus (HPV) in the etiology of cervical cancer and its precursor lesions. The ASCCP Guidelines for the management of women with CIN1, with CIN2,3 or with AIS are outlined along with the data supporting the recommendations and the reasons for age-appropriate management options. Post-treatment follow-up recommendations are also presented.
An understanding of the optimal management options for women with cervical squamous or glandular intraepithelial neoplasia is essential in providing appropriate care for women found to have these histologic abnormalities. This presentation strives to provide to clinicians responsible for the care of women a broad understanding of the optimal evidence-based management of women with cervical cancer precursors.
This evidence-based online activity was specifically designed to improve patient care, medical knowledge, practice-based learning, and systems-based practice gaps.
Learning Objectives
Upon completion of the learning activity and its post-test, participants should be able to:
- discuss the evolution of treatment of cervical precancer, the treatment options and the parameters that guide the choice of procedure;
- determine the best management options for women with CIN1;
- determine the best management options for women with CIN2,3; and,
- describe the data from numerous studies that provided the basis for the ASCCP Consensus Guidelines for the management of women with cervical cancer precursors.
Intended Audience
The target audience of the Online CME lecture entitled, "The ASCCP Guidelines for Management of Women with CIN and AIS" is all clinicians who make gynecologic decisions and manage women with cervical squamous and glandular intraepithelial neoplasia. This activity was designed to meet the continuing medical education needs of the practicing obstetrician-gynecologist, family physician, gynecologic oncologist, pathologist, obstetrics/gynecology or family medicine resident, nurse practitioner, certified nurse midwife, and physician's assistant.
Accreditation Statement
The American Society for Colposcopy and Cervical Pathology (ASCCP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians.
Continuing Medical Education (CME) Credit
The ASCCP designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Management of Conflicts of Interest and Contributed Funds
As an accredited provider of CME credit, ASCCP is required to comply with the ACCME's Standards for Commercial Support and has implemented a management process to ensure that anyone who is in a position to affect the content of the educational activity (e.g., faculty, planners, etc.) has disclosed to us all relevant financial relationships with any commercial interest and has ensured that those relationships do not influence presentation materials. All faculty have agreed to base their presentations on best available evidence. ASCCP discloses to learners any financial relationship(s) to healthcare-related commercial interests existing within the past 12 months to include the following information: 1) the name of the individual; 2) the name of the commercial interest; and, 3) the nature of the relationship the person has with each commercial interest. Slides and slide notes are reviewed for possible bias prior to the activity's release by the Accreditation Committee and peer-reviewers, and potential conflicts of interest are resolved prior to the live presentation. Any discussion of off-label use of products is noted when appropriate, as is discussion of any limitations on the information that is presented, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion. Disclosures of these commitments and/or relationships are published in these lecture materials and provided prior to the start of the activity, so the learners may formulate their own judgments regarding the presentation(s). Under ASCCP policy, anyone declining either to disclose or amend material to eliminate potential bias identified by the Accreditation Committee will be replaced.
Author, Reviewers, and Planners' Disclosure Information
The following are all reported disclosures of interest or potential conflicts from the 12 months preceding this activity:
J. Thomas Cox, MD (Author) - serves on the Data and Safety Monitoring Board for Merck & Co and receives a fee for his service. He is also a scientific advisory board member for Gen-Probe and an advisory board member for Abbott, for both of which he receives an honorarium.
Charles J. Dunton, MD (ASCCP Program Committee Chair/CME Reviewer) - serves on the speakers' bureaus of Merck & Co, GlaxoSmithKline, and Qiagen and receives honoraria. He also serves on an advisory board for Nycomed and receives an honorarium.
Hope K. Haefner, MD (CME Reviewer) - served on the speakers' bureau for Merck & Co and receives an honoraria. Effective March 2010 forward, she has had no financial relationships or conflicts to disclose.
Beth Colvin Huff, MSN, NP (CME Reviewer) - is a shareholder, receiving dividends with Hologic and serves on the speakers' bureaus of Merck & Co and Qiagen, for which she receives honoraria.
Those reporting no financial relationships or conflict of interest to disclose:
L. Stewart Massad, MD (Accreditation Committee Co-chair/CME Reviewer/Planner)
Herschel W. Lawson, MD (CME Reviewe/Accreditation Committee Co-chair)
Kathleen Poole (ASCCP Executive Director, Planner)
Carol Noonan (ASCCP Assistant Course Administrator, Planner)
CME Inquiries
For all CME certificate inquiries, please contact Ms. Carol Noonan at cnoonan@asccp.org or by mail at the ASCCP National Office, 152 West Washington Street, Hagerstown, MD 21740 or by phone at 301-733-3640.
|