Cervical cancer used to be a leading cause of cancer death for women — literally the #1 cause in the early 1900s.
Thankfully, through decades of quality cervical cancer screening and the introduction of the human papillomavirus (HPV) vaccine, the rates have dropped worldwide — especially in the United States where screening is (mostly) widespread. Rates of new cancers have plateaued at approximately 13,000 cases per year in the United States according to the CDC, but cervical cancer still kills nearly 4,000 U.S. women.
The vast majority of cervical cancer is caused by HPV. Cervical cancer screening via pap smears has been a true public health success story. So much so that guidelines (in the U.S.) have been increasingly less aggressive.
The guidelines most commonly followed in the United States are published by the American Society for Colposcopy and Cervical Pathology (ASCCP). But guidelines are also published by the American College of Obstetrics and Gynecologists (ACOG), the American Cancer Society (ACS), and the United States Preventive Services Task Force (USPSTF).
The good news is that unlike some other cancers (breast), these guidelines tend to be more similar than different. With the HPV vaccine, liquid pap smear screening, HPV co-testing, most of us have seen the frequency of screening change significantly over our careers. Screening isn’t initiated until age 21 for average-risk women, repeat testing every 3 years, then every 5 years after age 30 when performed with HPV co-testing.
Other similar changes exist in most other organizational guidelines. The ASCCP just released their latest update in April 2020 and simultaneously released an updated guidelines app. The ASCCP Management Guidelines App looks and feels dramatically different from the previous app. It will take users of the prior app some time to get used to it. The first time I used it I didn’t “get it” right away. But after using it for several patients/teaching with residents, it finally clicked.
ASCCP Management Guidelines App walks you through the guidelines based on your patients’ current/past data and provides recommendations for follow-up as well as a risk estimate for cervical cancer that is individualized to that particular patient.
This new version of the ASCCP Management Guidelines incorporates all of the latest ASCCP recommendations and tools for cervical cancer screening and follow-up in one outstanding POC app. The app walks the user through the process of screening and follow-up based on age, current/prior results to ensure the proper follow-up occurs. The app contains the full guidelines, graphics, and relevant publications all native to the device (no internet hyperlinks required).
What providers would benefit from this app?
Students, residents, mid-levels, primary care and Ob/Gyn providers and any provider who provides preventive services to women including cervical cancer screening, colposcopy, and follow-up.
- New design is easy, intuitive, and more functional than the old ASCCP app
- High-quality graphics, publications all native to device
- Available for Android
- Redesign takes some getting used to if you have always used the previous version
- App would benefit from improved directions, video guide, or similar
- PDFs can be challenging to read on the smaller smartphone screens
The newly refreshed ASCCP Management Guidelines app is an excellent tool for anyone involved in women’s health. The app is better organized and works better. The app still provides the latest guidelines from the ASCCP in a format that works as a decision support tool for your smartphone. Additionally, the app contains all of the guidelines, graphics, and relevant publications from the ASCCP. A must-have app for anyone who performs cervical cancer screening, colposcopy, etc.
Much improved interface (once you get used to it) with better organization, quality graphics, and all publications downloaded with the app.
o 5.0 stars
The app does not contain any outside links, but that is fine as the app has all of the relevant graphics and PDFs downloaded with the app. Makes for a very efficient experience navigating and reading materials in the app. Most are simply for reference, but outstanding that all of the appropriate publications are included in the app. The actual “tools” of deciding on follow-up is easy to navigate.
o 4 stars
App is $9.99.
o 5.0 stars
An app that no one in primary care involved in women’s health should be without. Although the price may turn some away, the app provides authoritative, evidence-based guidance using the most current guidelines to provide the best recommendations for follow-up on cervical cancer screening. This app ensures patients receive the proper screening, follow-up, treatment, and referral. Lives can literally be saved by using the app properly. The formatting of the new version takes a little getting used to, but overall is pretty intuitive. This latest version just makes the entire process easier and enjoyable.
Device Used For Review
o iPhone 11 Pro running iOS 13.6.
Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.