"Screen-and-treat" (also referred to as "see-and-treat" or "one-visit") protocols include a screening test followed in the same visit by treatment of positive results. This approach is only possible in settings where screening tests that produce immediate results (ie, rapid-result HPV testing, VIA) are available. This is in contrast to a multi-visit protocol which includes a screening test (eg, cervical cytology, standard HPV testing) followed by a second (or more) visit (with colposcopy and treatment) based on results from the screening test.
This algorithm describes screening in patients without HIV in resource-limited settings; screening in patients with HIV or in resource-rich settings is different and is described in related UpToDate content.
Screening in resource-limited settings is typically initiated at age 30 years; for patients in whom cervical cancer screening will be performed once or twice in a lifetime, we suggest screening between the ages of 30 and 39 years rather than other age ranges.HPV: human papillomavirus; LEEP: loop electrosurgical excision procedure; VIA: visual inspection with acetic acid; VILI: visual inspection with Lugol iodine; VIAM: visual inspection with or without magnification.
* Rapid-result HPV tests include Xpert HPV (Cepheid) and careHPV (Qiagen); these tests are described in detail in related UpToDate content.
¶ Visual inspection can be performed with acetic acid, Lugol iodine, and with or without magnification. In general, VIA is preferred over VILI and VIAM.
Δ Thermal ablation may also be used in settings where LEEP or cryoablation technologies are not available.