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Management of Intraepithelial Lesions of the Cervix

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  • First Online:
Handbook of Gynecology

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Abstract

Cervical cancer is the most common gynecologic malignancy worldwide, with a particularly significant presence in developing nations. In the USA, significant reductions in the incidence of cervical cancer have been achieved through improved screening and treatment of precancerous lesions. The screening guidelines have continued to evolve with the most recent guidelines published by the American Society for Colposcopy and Cervical Pathology (ASCCP) in 2019. The major change from 2012 guidelines is a shift from test result–based algorithms to risk-based guidelines. These guidelines describe the screening process and outline the recommended management for abnormal findings. Screening for cervical cancer consists of cervical cytology and/or HPV testing. The timing and selection of these tests depends on the woman’s age. If abnormalities are found in screening, the next step is typically colposcopy for directed biopsies depending on individual risk for CIN (cervical intraepithelial neoplasia) 3 or higher. If those biopsies identify cervical intraepithelial neoplasia, treatment may be recommended with excisional procedures or ablation depending on the level of abnormality and age of the patient. Ultimately, the goal of cervical cancer screening is twofold: first, to identify patients at higher risk of progression to CIN 3, AIS (adenocarcinoma in situ), and invasive cancer based on a more nuanced understanding of HPV (human papillomavirus) as it relates to the progression of cervical dysplasia, and second, to treat abnormal lesions.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA

    Rasika R. Deshpande, Caroline J. Violette, Morgan Elizabeth Fullerton & Marcia A. Ciccone

Authors
  1. Rasika R. Deshpande
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  2. Caroline J. Violette
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  3. Morgan Elizabeth Fullerton
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  4. Marcia A. Ciccone
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Corresponding author

Correspondence to Rasika R. Deshpande .

Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Donna Shoupe

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Deshpande, R.R., Violette, C.J., Fullerton, M.E., Ciccone, M.A. (2023). Management of Intraepithelial Lesions of the Cervix. In: Shoupe, D. (eds) Handbook of Gynecology. Springer, Cham. https://doi.org/10.1007/978-3-031-14881-1_19

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  • DOI: https://doi.org/10.1007/978-3-031-14881-1_19

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-14880-4

  • Online ISBN: 978-3-031-14881-1

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