Bibliographic information
Recommendation
Recommendations for the general population of women . In settings with low follow-up capacity (less than 60%) and sufficient ablative treatment capacity, WHO suggests:
- treating all eligible women with ablative treatment who test positive for any
carcinogenic HPV (cHPV) types 16 (group 1a), 18 and 45 (group 1b), 31, 33, 35, 52 and 58 (group 1c), 39, 51, 56 and 59 (group 1d), consistent with a no-genotyping approach;
- OR treating eligible women with ablative treatment who test positive for any cHPV
types 16 (group 1a), 18 and 45 (group 1b) and 31, 33, 35, 52 and 58 (group 1c) [This can be done using an 8-cHPV type test (tests designed to detect the eight most cHPV types) as per WHO target product profiles for HPV screening tests, or when using extended genotyping HPV tests.] OVER
- treating all eligible women with ablative treatment who test positive for cHPV types
16 (group 1a), 18 and 45 (group 1b) AND triaging women who test positive for cHPV types 31, 33, 35, 52, 58, 39, 51, 56 and 59 (groups 1c and 1d); or OVER
- triaging with additional tests all women who test positive for any cHPV types (1a, 1b,
1c and 1d).
Recommended in favor
Conditional
Certainty of evidence
Low
Notes and Remarks
As the number of visits increases, the risk of loss to follow-up also rises. Although the preferred strategies may result in some overtreatment, they reduce losses to follow-up among women with pre-cancerous lesions who are at high risk of progression to cervical cancer if left untreated.