Low Risk of Cervical Cancer/Precancer Among Most Women Under Surveillance Postcolposcopy.
J Low Genit Tract Dis
; 22(2): 97-103, 2018 Apr.
Article
in En
| MEDLINE
| ID: mdl-29570564
ABSTRACT
OBJECTIVE:
To inform impending postcolposcopy guidelines, this analysis examined the subsequent risk of CIN 3+ among women with a grade lower than CIN 2 (< CIN 2) colposcopy results, taking into account the referring results that brought them to colposcopy and cotest results postcolposcopy.METHODS:
We analyzed 107,005 women from 25 to 65 years old, recommended for colposcopy at Kaiser Permanente Northern California. We estimated absolute risks of CIN 3+ among women (1) recommended for colposcopy (precolposcopy), (2) following colposcopy and with histology results < CIN 2 (postcolposcopy), and (3) with cotest results 12 months after a < CIN 2 colposcopy (return cotest).RESULTS:
After colposcopy showing < CIN 2 (n = 69,790; 87% of the women at colposcopy), the 1-year risk of CIN 3+ was 1.2%, compared with 6.3% at the time of colposcopy recommendation. Negative cotest results 1 year after colposcopy identified a large group (37.1%) of women whose risk of CIN 3+ (i.e., <0.2% at 3 years after postcolposcopy cotest) was comparable with women with normal cytology in the screening population. These risks are consistent with current guidelines recommending repeat cotesting 12 months after colposcopy < CIN 2 and a 3-year return for women with a negative postcolposcopy cotest.CONCLUSIONS:
Most women are at low risk of subsequent CIN 3+ after a colposcopy showing < CIN 2, especially those who are human papillomavirus-negative postcolposcopy, consistent with current management guidelines for repeat testing intervals. Before the finalizing the upcoming guidelines, we will consider additional rounds of postcolposcopy cotesting.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Precancerous Conditions
/
Uterine Cervical Dysplasia
/
Uterine Cervical Neoplasms
/
Colposcopy
Type of study:
Etiology_studies
/
Guideline
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Middle aged
Country/Region as subject:
America do norte
Language:
En
Journal:
J Low Genit Tract Dis
Journal subject:
GINECOLOGIA
Year:
2018
Type:
Article
Affiliation country:
Moldova