🧬rhisk📊

Current Test Results & Demographics

Patient Age *

Screening Type *

Cytology Result *

HPV Test Result *

Note: HPV testing with genotyping is preferred for optimal risk stratification. If genotyping is not available, select "HPV Positive (genotype unknown)".

Screening & Colposcopy History

Most Recent Negative HPV Test

Previous Abnormal Results (Check all that apply)

ASC-US LSIL ASC-H HSIL AGC HPV Positive

Recent Colposcopy (within 12 months)

Highest Grade Previously Found on Biopsy

Previous Treatment

Date of Most Recent Treatment

Additional Risk Factors & Special Populations

Special Populations

Currently pregnant Immunocompromised (HIV+, transplant, immunosuppressive therapy) In utero DES exposure

Clinical Presentation

Post-coital bleeding Abnormal uterine bleeding Visible cervical lesion

Additional Clinical Notes (Optional)

Risk Assessment & Management Recommendations

CIN3+ Risk Assessment

--%

Immediate Risk

25%

60%

Management Recommendation

Clinical Summary

Documentation for Medical Record

References

Perkins RB, Guido RS, Castle PE, et al. 2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors. J Low Genit Tract Dis. 2020;24(2):102-131.
Egemen D, Cheung LC, Chen X, et al. Risk Estimates Supporting the 2019 ASCCP Risk-Based Management Consensus Guidelines. J Low Genit Tract Dis. 2020;24(2):132-143.
Massad LS, Einstein MH, Huh WK, et al. 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. J Low Genit Tract Dis. 2013;17(5 Suppl 1):S1-S27.
Schiffman M, Wentzensen N, Perkins RB, Guido RS. An Introduction to the 2019 ASCCP Risk-Based Management Consensus Guidelines. J Low Genit Tract Dis. 2020;24(2):87-89.