Management of discordant colposcopic impression, histopathology and referral LBC prediction

Unresolved issues

There is currently insufficient high-level evidence to guide the management of discrepancies between cytological findings and colposcopic impression in women who have positive oncogenic HPV test results, or who have pLSIL/LSIL and Type 3 TZ colposcopy. These consensus-based recommendations and practice points are considered conservative and offer a safe approach, but this may require review as future research results become available.

Future research priorities

To determine optimal management, evidence is needed from:

• prospective audits of management strategies of large cohorts of women who have positive oncogenic HPV test results with discordant cytology and colposcopic findings
• randomised controlled trials or longitudinal studies comparing management strategies for women with a positive oncogenic HPV test result, who have normal cytology or pLSIL/LSIL, and Type 3 TZ colposcopy.

Author(s):

• Dr Andrea Garrett — Co-author
• Professor Ian Hammond — Co-author
• Professor Marion Saville — Co-author
• Mr. C. David H. Wrede — Co-author
• Cancer Council Australia Cervical Cancer Screening Guidelines Working Party — Co-author

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