{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T01:58:53Z","timestamp":1773367133220,"version":"3.50.1"},"reference-count":46,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: The approach to adenocarcinoma in situ (AIS) is challenged by diagnostic complexity, limited high-quality evidence, and heterogeneous guidance. Methods: We conducted a narrative comparative review of global guidelines\/recommendations (2012\u20132025; search updated 1 October 2025), extracting data across 38 topics related to AIS management and classifying indications into five categories of coverage\/consensus. Results: Twenty documents from national or supranational bodies were included. A cross-guideline consensus emerged on eight core items (colposcopy for any glandular cytologic abnormality; role of HPV test; mandatory histologic confirmation; excisional treatment for histologic AIS; re-excision when margins are involved; criteria and type of hysterectomy; and expert\/centralized management). Operational variability emerged in the excisional technique, pathways for discordant results, management during pregnancy, and follow-up protocols. Divergent guidance was most evident for indications to endocervical sampling, criteria for conservative management, and the need for hysterectomy after completed childbearing. Limited-coverage consensus involved the technique of initial histologic sampling, endometrial assessment, and pathways for cytology subtypes. Several areas remained unaddressed. Conclusions: While the essential management of AIS is well defined, uncertainty increases when treatment must be personalized. A core outcome set and rigorous multicenter studies are needed to reduce heterogeneity and enable truly evidence-based personalization.<\/jats:p>","DOI":"10.3390\/life16030461","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T14:43:18Z","timestamp":1773240198000},"page":"461","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Global Comparative Review of Guidelines for Cervical Adenocarcinoma In Situ"],"prefix":"10.3390","volume":"16","author":[{"given":"Giovanni","family":"Delli Carpini","sequence":"first","affiliation":[{"name":"Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Science, Universit\u00e0 Politecnica delle Marche, 60123 Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camilla","family":"Cicoli","sequence":"additional","affiliation":[{"name":"Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Science, Universit\u00e0 Politecnica delle Marche, 60123 Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Bernardi","sequence":"additional","affiliation":[{"name":"Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Science, Universit\u00e0 Politecnica delle Marche, 60123 Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jasmine","family":"Saee","sequence":"additional","affiliation":[{"name":"Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Science, Universit\u00e0 Politecnica delle Marche, 60123 Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Petrini","sequence":"additional","affiliation":[{"name":"Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Science, Universit\u00e0 Politecnica delle Marche, 60123 Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Science, Universit\u00e0 Politecnica delle Marche, 60123 Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6162-6299","authenticated-orcid":false,"given":"Jacopo","family":"Di Giuseppe","sequence":"additional","affiliation":[{"name":"Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Science, Universit\u00e0 Politecnica delle Marche, 60123 Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6405-8522","authenticated-orcid":false,"given":"Luca","family":"Giannella","sequence":"additional","affiliation":[{"name":"Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Science, Universit\u00e0 Politecnica delle Marche, 60123 Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2424-2691","authenticated-orcid":false,"given":"Giuseppe","family":"Vizzielli","sequence":"additional","affiliation":[{"name":"Unit of Obstetrics and Gynecology, \u201cSanta Maria della Misericordia\u201d University Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8037-4947","authenticated-orcid":false,"given":"Andrea","family":"Ciavattini","sequence":"additional","affiliation":[{"name":"Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Science, Universit\u00e0 Politecnica delle Marche, 60123 Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"453","DOI":"10.5858\/arpa.2012-0493-RA","article-title":"The spectrum of cervical glandular neoplasia and issues in differential diagnosis","volume":"138","author":"Loureiro","year":"2014","journal-title":"Arch. 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