Risk Estimates Supporting the 2019 ASCCP Risk-Based Management Consensus Guidelines

The 2019 ASCCP Risk-Based Management Consensus Guidelines (Perkins and Guido et al.) for the management of cervical cancer screening abnormalities recommend 1 of 6 clinical actions (treatment, optional treatment or colposcopy/biopsy, colposcopy/biopsy, 1-year surveillance, 3-year surveillance, 5-year return to regular screening) based on the risk of cervical intraepithelial neoplasia grade 3, adenocarcinoma in situ, or cancer (CIN 3+) for the many different combinations of current and recent past screening results. The tables presented here display the risk estimates of CIN 3+, as well as CIN 2+ and cancer for every possible combinations of test result as the data permits. These risk scores are obtained at time points, 0 (immediate), 1, 2, 3, 4, and 5 years. Each risk estimate is presented with its corresponding standard error (SE) and 95% lower (LL95) and upper (UL95) confidence interval. Test results are ordered chronologically; therefore, in each table the leftmost column presents the oldest test result in the screening history of the patient while the rightmost column(s) (among the test results) displays the current test result. The total sample size (N) in each category and each screening result as a percentage (%) of total screened, the total number of patients informative in risk estimation (N Informative) are listed in the columns following the test results. Total number of observed CIN 2+, CIN 3+, and cancer cases are displayed together with the breakdown of prevalence, incidence, and unknown prevalence/incidence in the subsequent columns. Following the risk estimates columns, recommended management and “Recommendation Confidence Score” (for more details about this score please refer to Egemen et al.) are listed. Sampling weights are used for the sample from which we obtained the risk estimates for the HPV genotyping test results as explained in the article Demarco et al. The raw sample sizes (without the sampling weights) are presented at the rightmost columns of each table. The Statistical methods for risk estimation is explained in the article Cheung et al.

Generation of these risk estimates was supported by the Intramural Research Program of the National Cancer Institute. The risk estimates are in the public domain in the United States of America and are made freely available elsewhere.