Management of histologically confirmed high-grade glandular abnormalities

Whilst at this time indefinite co-testing is recommended, the ongoing monitoring of the renewed NCSP may provide data in the future to support the safety of discharging women who have been negative for both HPV and cytology on multiple occasions at an earlier point.

Well-designed prospective research studies are needed to compare the use of cold knife cone biopsy with diathermy loop excision (LEEP or LLETZ) in the diagnosis and treatment of AIS. If such a study were to show that loop excision was non-inferior to cold-knife cone biopsy for the outcomes of post-treatment recurrent and adenocarcinoma, loop excision could be recommended as an appropriate treatment option for AIS. This would benefit women because, unlike cold-knife cone procedures, loop excision does not require hospital admission and general anaesthesia. 

Studies evaluating endocervical curettage would provide useful evidence to determine its role in clinical practice. 

Long-term data from the National Cancer Screening Register should be analysed to determine the minimal effective surveillance period for women undergoing annual Test of Cure for posttreatment AIS before returning to routine 5-yearly screening.

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