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Interim Guidelines for Management of Abnormal Cervical Cytology

Robert J. Kurman, MD; Donald E. Henson, MD; Arthur L. Herbst, MD; Kenneth L. Noller, MD; Mark H. Schiffman, MD; Thomas Bonfiglio, MD; Henry Buck, MD; Christopher Crum, MD; John P. Curtin, MD; Mitchell Greenberg, MD; Kenneth Hatch, MD; Donald Earl Henson, MD; A. Bennett Jenson, MD; Peter Johnson, MD; Howard Jones III, MD; Harold Kaminetsky, MD; Luella Klein, MD; Leopold Koss, MD; Burton Krumholz, MD; Nancy Lee, MD; Ronald Luff, MD; Jeanne Mandelblatt, MD, MPH; Richard Reid, MD; Ralph Richart, MD; Thomas Sedlacek, MD; Charles Sneiderman, MD; Diane Solomon, MD; Mark Stoler, MD; Floyd Taub, MD; Edward Trimble, MD; Ernest Tucker III, MD; Leo B. Twiggs, MD; Edward Wilkinson, MD; Barbara Atkinson, MD; Harvey E. Averette, MD; William Creasman, MD; Sandra Fryhofer, MD; Julie Noy, MD; Mary Nielsen, MD; Kenneth Noller, MD; Robert Park, MD; Douglas Westhoff, MD
JAMA. 1994;271(23):1866-1869. doi:10.1001/jama.1994.03510470070037.
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THE INCIDENCE of and mortality from cervical cancer in the United States have decreased dramatically over the past 40 years, in part because of early diagnosis and treatment of cervical cancer precursor lesions. The success of cervical cytological screening has served as a model for early diagnosis of other types of cancer. Although numerous studies have shown that lack of cytological screening is a major risk factor for the development of invasive cervical cancer,1-3 it is important to emphasize that none of the screening, diagnostic, or therapeutic techniques used in medicine are perfect. Accordingly, a few women will develop cervical cancer despite adherence to accepted screening protocols. In addition, problems inherent with sampling, interpretation, and effective clinical follow-up preclude total prevention of cervical cancer.

In recent years it has become evident that the cost and morbidity associated with the detection and treatment of low-grade cervical lesions have escalated, probably

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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