Clinical Guidelines & Recommendations for the Management of Cervical Intraepitelial Lesions at the Clínica de Tumors María & Josefa Barbero-Fundación La Piedad & Instituto Nacional del Cancer

Abstract

Background: For decades, cervical cancer has been one of the leading causes of mortality among women in Paraguay and represents a significant public health problem. This situation may be associated with an increased incidence of invasive cervical cancer and precursor lesions, together with deficiencies in their diagnosis and appropriate management.

Objective: To provide clinical guidelines and recommendations for the diagnosis, management and treatment of patients with biopsy-confirmed cervical intraepithelial neoplasia.

Materials and methods: Different aspects of the diagnosis, management and treatment of cervical cancer precursor lesions were evaluated through an updated evidence-based review. MEDLINE, The Cochrane Library and the National Comprehensive Cancer Network Clinical Practice Guidelines were consulted. The evidence was supplemented by the experience of participating professionals and adapted to local needs.

Results: Clinical guidelines and recommendations were developed for managing patients with cervical intraepithelial neoplasia at the María & Josefa Barbero Tumor Clinic-Fundación La Piedad and the National Cancer Institute. Recommendations were established for CIN 1, CIN 2 and CIN 3 lesions, including follow-up, treatment options and special clinical circumstances.

Conclusion: These clinical guidelines will help unify criteria, standardize procedures and improve the quality of patient treatment, while providing specialists with a systematic approach adapted to the national context.