Cervical Cytology Practice Guideline
Approved by the ASC Executive Board November 10, 2000
I.A. Purpose, Intended Audience, and Limitations
Practice guidelines are used by diverse segments of the medical community to define and communicate standards of performance and care. To date, the American Medical Association has catalogued nearly 2,000 clinical practice guidelines or equivalent documents. 3An additional source on practice Guidelines is the web site www.guideline.gov (National Guideline Clearinghouse) that is sponsored by the Agency for Health Research and Quality (AHRQ) formally the Agency for Health Care Policy and Research in partnership with the American Medical Association and the American Association of Health Plans .
The Cervical Cytology Practice Guideline is a document for laboratories and is intended for use primarily by cytologists – pathologists and cytotechnologists – who perform cervical cytology analyses and report their findings to clinicians. Thus, this document focuses on laboratory processes and related topics such as techniques of sample procurement, slide staining and analysis, and cytology laboratory management. This guideline is intended for use by laboratorians; however, clinicians, patients, and others involved in women’s healthcare will find this document to be a resource in making clinical care decisions.
The process of creating Guideline represents consensus building within a specialty with subsequent endorsement by national professional organizations. In light of rapidly evolving science and technology, a guideline devoted to cervical cytology requires timely review and revision. This guideline serves not as a specific blueprint or set of dictates, but as a device to assist standardization and continuous quality improvement efforts. It is with this understanding that the American Society of Cytopathology promulgates this Cervical Cytology Practice Guideline.
I.B. Context and Scope
The emphasis of this guideline is on cervical cytology specimen procurement, analysis, reporting and management. Specific microscopic criteria for interpretation are not included since these have been well described in textbooks, symposia and workshops. A detailed analysis of related clinical topics such as patient care algorithms for follow up of abnormal cervical cytology results, are also beyond the scope of this document.
An important general limitation is that this guideline, in many respects, is applicable for laboratories in the United States only. Many of its elements are defined or specified in United States government agency regulations.
I.C. Variability of Practice
This document highlights procedural and interpretive areas where there are variations in practices, and areas where there is consensus for “best practices”. Where the literature is conflicting, absent, or consists only of case reports rather than more comprehensive studies, this document describes different laboratory practices.
1 Institute of Medicine (IOM), Committee on Clinical Practice Guideline. Guideline for Clinical Practice – From Development to Use. Field MJ, Lohr KN, (eds.). Washington, D.C: National Academy Press; 1992, p 8.