Reduction in colposcopy workload and associated clinical activity following human papillomavirus (HPV) catch-up vaccination programme in Scotland: an ecological study.
BJOG
; 124(9): 1386-1393, 2017 Aug.
Article
em En
| MEDLINE
| ID: mdl-28102928
ABSTRACT
OBJECTIVE:
To measure patterns of clinical activity at colposcopy before and after vaccinated women entered the Scottish Cervical Screening Programme (SCSP).DESIGN:
Population-based observational study using nationally collected data.SETTING:
Scottish colposcopy clinics. SAMPLE All women with a date of birth on or after 1 January 1985 who attended colposcopy in Scotland between 2008 and 2014.METHODS:
Routinely collected data from the Scottish National Colposcopy Clinical Information Audit System (NCCIAS) were extracted, including referral criteria, referral cervical cytology, colposcopic findings, clinical procedures, and histology results. Analysis was restricted to those referred to colposcopy at age 20 or 21 years. MAIN OUTCOMEMEASURES:
Referral criteria, positive predictive value of colposcopy, default rates, and rates of cervical biopsies and treatments.RESULTS:
A total of 7372 women referred for colposcopy at age 20 or 21 years were identified. There was a downward trend in the proportion of those referred with abnormal cytology (2008/9, 91.0%; 2013/14, 90.3%; linear trend P = 0.03). Women were less likely to have diagnostic or therapeutic interventions. The proportion with no biopsy (2008/9, 19.5%; 2013/14, 26.9%; linear trend P < 0.0001) and no treatment (2008/9, 74.9%; 2013/14, 91.8%; linear trend P < 0.0001) increased over the period of observation.CONCLUSIONS:
A reduction in clinical activity related to abnormal screening referrals is likely to be associated with the human papillomavirus (HPV) catch-up immunisation programme. Referral criteria and the service provision of colposcopy needs to be planned carefully, taking account of the increasing number of women who have been immunised against HPV that will be entering cervical screening programmes worldwide. TWEETABLE ABSTRACT Colposcopy referral criteria and service planning need attention following HPV immunisation programme.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Displasia do Colo do Útero
/
Neoplasias do Colo do Útero
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Carga de Trabalho
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Colposcopia
/
Infecções por Papillomavirus
/
Vacinas contra Papillomavirus
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Utilização de Procedimentos e Técnicas
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
BJOG
Assunto da revista:
GINECOLOGIA
/
OBSTETRICIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Reino Unido