Diagnosis and Management of Precancerous Cervical Lesions

Over the past five decades, the Pap smear for cervical cancer screening has become standard of care across the United States and other countries, and its implementation in the routine gynecologic examination has dramatically reduced the rates of invasive cervical cancer. As we have come to understand the nuances of this routine screening and are increasingly better able to identify precancerous cervical lesions, we have also developed improved screening and treatment modalities. This progress has led to ever-changing diagnostic andmanagement guidelines. Over the last several years, the American Society for Colposcopy and Cervical Pathology (ASCCP) has revised its guidelines for cervical cancer screening and issued new recommendations for treatment and management of cervical dysplasia. In addition, investigators across the world are exploring improved methods of screening, treatment, and identification of precancerous cervical lesions. Such methods include optimizing HPV testing, genotyping HPV and identifying associations with cervical dysplasia, and optimizing the timing and efficacy of treatment. This article will review and critically evaluate the literature published within the past year with regard to the diagnosis and management of precancerous cervical lesions.