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ASCCP Colposcopy Standards: Colposcopy Quality Improvement Recommendations for the United States
Edward J Mayeaux1, Akiva P Novetsky, David Chelmow
11USC Department of Family and Preventive Medicine University of South Carolina School of Medicine, Columbia, SC; 2Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY; 3Albert Einstein College of Medicine and Montefiore Medical Center Cancer Center, Bronx, NY; 4Department of Obstetrics and Gynecology, Virginia Commonwealth University School of Medicine, Richmond, VA; 5Pima County Health Department, Tucson AZ; 6Women's Health Nurse Practitioner, Scotch Plains, NJ; 7Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD; 8Preventive Medicine Residency Program, Palmetto Health/University of South Carolina School of Medicine, Columbia, SC; 9Department of Obstetrics, Gynecology, & Women's Health, Rutgers New Jersey Medical School, Newark, NJ; 10Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University of Medicine, St. Louis, MO; 11Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD; 12Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, Albuquerque, NM; 13Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO; 14Departments of Obstetrics and Gynecology, and Adult and Family Medicine, Kaiser Permanente Northern California, San Leandro, CA; and 15Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alabama at Birmingham School of Medicine, Birmingham, AL.
Objectives:
The American Society for Colposcopy and Cervical Pathology (ASCCP) Colposcopy Standards recommendations address the role of and approach to colposcopy and biopsy for cervical cancer prevention in the United States. The recommendations were developed by an expert working group appointed by ASCCP's Board of Directors. The ASCCP Quality Improvement Working Group developed evidence-based guidelines to promote best practices and reduce errors in colposcopy and recommended indicators to measure colposcopy quality.
Materials And Methods:
The working group performed a systematic review of existing major society and national guidelines and quality indicators. An initial list of potential quality indicators was developed and refined through successive iterative discussions, and draft quality indicators were proposed. The draft recommendations were then reviewed and commented on by the entire Colposcopy Standards Committee, posted online for public comment, and presented at the International Federation for Cervical Pathology and Colposcopy 2017 World Congress for further comment. All comments were considered, additional adjustments made, and the final recommendations approved by the entire Task Force.
Results:
Eleven quality indicators were selected spanning documentation, biopsy protocols, and time intervals between index screening tests and completion of diagnostic evaluation.
Conclusions:
The proposed quality indicators are intended to serve as a starting point for quality improvement in colposcopy at a time when colposcopy volume is decreasing and individual procedures are becoming technically more difficult to perform.
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