Management of women with abnormal cervical cytology: Update of French guidelines after the implementation of HPV screening
To update the French national cancer institute (INCa) guidelines for the management of women with abnormal cervical cytology. In 2016, INCa published guidelines for the management of women with abnormal cervical cytology. In 2019, however, the national authority for Health (HAS) recommended that the test for human papillomavirus be used to screen for cervical cancer in women over 30. It therefore became necessary to update the initial management and follow-up of women who had a positive test followed by abnormal reflex cytology findings. We used modified Delphi methods. The 3 members of the organizing committee revised each decision tree and then presented them to 35 experts over 2 rounds, to obtain their agreement about their validity and clarity. This formalized consensus of experts allowed the creation of 17 decision trees instead of 15 previously: 13 on the diagnosis management of abnormal cytology, stratified by age, and 4 by therapeutic indications in abnormal histology. The median agreement scores were 89 % (interquartile range 81 %-97 %). These 17 decision trees present different situations encountered by various health professionals and guide them, depending on their specialties, in providing initial or follow-up management or delegating care.