ASCCP Protocols

Question 1

Unsatisfactory Cytology (any age)

Answer 1

repeat cytology in 2-4 months. can do colpo if >30 years old and HPV+

Question 2

Cytology NILM but EC/TZ absent or insufficient, ages 21-29, any HPV status

Answer 2

routine screening

Question 3

Cytology NILM but EC/TZ absent of insufficient, ages 30+, HPV unknown

Answer 3

HPV testing (preferred) OR repeat cytology in 3 years (acceptable)

Question 4

Cytology NILM but EC/TZ absent of insufficient, ages 30+, HPV+

Answer 4

cytology and HPV in one year or genotyping

Question 5

Cytology NILM but EC/TZ absent of insufficient, ages 30+, HPV-

Answer 5

routine screening

Question 6

cytology negative but >30 and HPV+

Answer 6

repeat cotesting in one year or HPV DNA testing

Question 7

ASCUS ages 21-24, HPV unknown

Answer 7

repeat cytology in one year or HPV testing

Question 8

ASCUS ages 21-24, HPV-

Answer 8

routine screening

Question 9

ASCUS ages 21-24 HPV+

Answer 9

repeat cytology in 12 months

Question 10

ASCUS ages 25+ HPV unknown

Answer 10

repeat cytology in 1 year (acceptable) or HPV testing (preferred)

Question 11

ASCUS ages 25+ HPV+

Answer 11

colpo

Question 12

ASCUS ages 25+ HPV-

Answer 12

repeat cotesting in 3 years

Question 13

LSIL ages 21-24

Answer 13

repeat cytology in 12 months, unless known HPV- then routine screening

Question 14

LSIL ages 25+ HPV unknown or +

Answer 14

colpo

Question 15

LSIL ages 25+ HPV-

Answer 15

repeat cotesting in 1 year or colpo (acceptable)

Question 16

ASC-H

Answer 16

any age and any HPV status= colpo

Question 17

AGC with atypical endometrial cells

Answer 17

endometrial and endocervical sampling

Question 18

AGC other subcategories

Answer 18

colpo with endocervical sampling and endometiral sampling if >30

Question 19

no lesion, or biopsy confirmed CIN1 preceded by lessor abnormalities, ages 21-24

Answer 19

repeat cytology in 12 months

Question 20

no lesion, or biopsy confirmed CIN1 preceded by ASC-H or HSIL, ages 21-24, colpo adequate:

Answer 20

diagnostic excision procedure OR observation with colpo at 6mos and 1 yr

Question 21

no lesion, or biopsy confirmed CIN1 preceded by ASC-H or HSIL, ages 25+

Answer 21

cotesting at 12 and 24 months or diagnostic excision procedure

Question 22

no lesion, or biopsy confirmed CIN1 preceded by lessor abnormalities ages 25+

Answer 22

repeat cotesting at 12 months

Question 23

biopsy confirmed CIN2 and CIN3 ages 21-24

Answer 23

CIN2- observation with colpo and cytology at 6 months and one year
CIN3 excision or ablation of T zone

Question 24

biopsy confirmed CIN2 and CIN3 ages 25+

Answer 24

colpo adequate: excision/ablation of TZ

colpo inadequate: diagnostic excisional procedure

Question 25

AIS diagnosis

Answer 25

hysterectomy preferred

Question 26

no lesion, or biopsy confirmed CIN1 preceded by ASC-H or HSIL, ages 21-24, colpo inadequate:

Answer 26

diagnostic excision procedure