Postcolposcopy management strategies for women referred with low-grade squamous intraepithelial lesions or human papillomavirus DNA–positive atypical squamous cells of undetermined significance: A two-year prospective study
Objective: This study was undertaken to compare postcolposcopy management strategies for women referred for low-grade squamous intraepithelial lesions (LSIL) or oncogenic human papillomavirus (HPV) DNA–positive atypical squamous cells of undetermined significance (ASCUS), with cervical intraepitheli...
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| Veröffentlicht in: | American journal of obstetrics and gynecology 2003-06, Vol.188 (6), p.1401-1405 |
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| container_title | American journal of obstetrics and gynecology |
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| creator | Guido, Richard Schiffman, Mark Solomon, Diane Burke, Louis |
| description | Objective: This study was undertaken to compare postcolposcopy management strategies for women referred for low-grade squamous intraepithelial lesions (LSIL) or oncogenic human papillomavirus (HPV) DNA–positive atypical squamous cells of undetermined significance (ASCUS), with cervical intraepithelial neoplasia (CIN) grade 1 or less found at initial colposcopy. Study Design: A 2-year prospective follow-up of 1539 women was designed to assess the percentage sensitivity of different postcolposcopy management strategies to detect subsequent CIN grade 2 or 3 and percentage referral to repeat colposcopy. Results: HPV testing at 12 months was sensitive (92.2%) for detection of CIN grade 2 or 3 with a referral rate to repeat colposcopy of 55.0%. Repeat semiannual cytology with referral to colposcopy at an ASCUS threshold demonstrated similar sensitivity (88.0%) but with a higher rate of referral to colposcopy (63.6%). Combining cytology and HPV testing did not increase sensitivity and hurt specificity. Baseline viral load and colposcopic impression were not helpful. Conclusion: The most efficient test for identifying women with CIN grade 2 or 3 after colposcopy might be an HPV test alone at 12 months. (Am J Obstet Gynecol 2003;188:1401-5.) |
| doi_str_mv | 10.1067/mob.2003.456 |
| format | Article |
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Study Design: A 2-year prospective follow-up of 1539 women was designed to assess the percentage sensitivity of different postcolposcopy management strategies to detect subsequent CIN grade 2 or 3 and percentage referral to repeat colposcopy. Results: HPV testing at 12 months was sensitive (92.2%) for detection of CIN grade 2 or 3 with a referral rate to repeat colposcopy of 55.0%. Repeat semiannual cytology with referral to colposcopy at an ASCUS threshold demonstrated similar sensitivity (88.0%) but with a higher rate of referral to colposcopy (63.6%). Combining cytology and HPV testing did not increase sensitivity and hurt specificity. Baseline viral load and colposcopic impression were not helpful. Conclusion: The most efficient test for identifying women with CIN grade 2 or 3 after colposcopy might be an HPV test alone at 12 months. (Am J Obstet Gynecol 2003;188:1401-5.)</description><identifier>ISSN: 0002-9378</identifier><identifier>EISSN: 1097-6868</identifier><identifier>DOI: 10.1067/mob.2003.456</identifier><identifier>PMID: 12824969</identifier><identifier>CODEN: AJOGAH</identifier><language>eng</language><publisher>Philadelphia, PA: Mosby, Inc</publisher><subject>Adolescent ; Adult ; Aged ; Biological and medical sciences ; Carcinoma, Squamous Cell - diagnosis ; Carcinoma, Squamous Cell - pathology ; Carcinoma, Squamous Cell - surgery ; Carcinoma, Squamous Cell - virology ; Cervical Intraepithelial Neoplasia - diagnosis ; Cervical Intraepithelial Neoplasia - pathology ; Cervical Intraepithelial Neoplasia - surgery ; Cervical Intraepithelial Neoplasia - virology ; Cervical intraepithelial neoplasia grade 1 ; cervix ; clinical management ; colposcopy ; Colposcopy - standards ; cytology ; DNA, Viral - genetics ; Female ; Female genital diseases ; Follow-Up Studies ; Genital system. Mammary gland ; Gynecology. Andrology. Obstetrics ; human papillomavirus ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Medical sciences ; Middle Aged ; Neoplasm Staging ; Non tumoral diseases ; Papillomaviridae - genetics ; Papillomaviridae - isolation & purification ; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques ; Prospective Studies ; Randomized Controlled Trials as Topic ; Sensitivity and Specificity ; Triage ; Uterine Cervical Neoplasms - diagnosis ; Uterine Cervical Neoplasms - pathology ; Uterine Cervical Neoplasms - surgery ; Uterine Cervical Neoplasms - virology ; Vaginal Smears</subject><ispartof>American journal of obstetrics and gynecology, 2003-06, Vol.188 (6), p.1401-1405</ispartof><rights>2003 Mosby, Inc.</rights><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c364t-21d5c6cad65cea11eb8fcee1036bbc869db5a92c6134de58812c74667d29071b3</citedby><cites>FETCH-LOGICAL-c364t-21d5c6cad65cea11eb8fcee1036bbc869db5a92c6134de58812c74667d29071b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1067/mob.2003.456$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14922148$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12824969$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Guido, Richard</creatorcontrib><creatorcontrib>Schiffman, Mark</creatorcontrib><creatorcontrib>Solomon, Diane</creatorcontrib><creatorcontrib>Burke, Louis</creatorcontrib><creatorcontrib>for the ASCUS LSIL Triage Study (ALTS) Group</creatorcontrib><creatorcontrib>ASCUS LSIL Triage Study (ALTS) Group</creatorcontrib><title>Postcolposcopy management strategies for women referred with low-grade squamous intraepithelial lesions or human papillomavirus DNA–positive atypical squamous cells of undetermined significance: A two-year prospective study</title><title>American journal of obstetrics and gynecology</title><addtitle>Am J Obstet Gynecol</addtitle><description>Objective: This study was undertaken to compare postcolposcopy management strategies for women referred for low-grade squamous intraepithelial lesions (LSIL) or oncogenic human papillomavirus (HPV) DNA–positive atypical squamous cells of undetermined significance (ASCUS), with cervical intraepithelial neoplasia (CIN) grade 1 or less found at initial colposcopy. Study Design: A 2-year prospective follow-up of 1539 women was designed to assess the percentage sensitivity of different postcolposcopy management strategies to detect subsequent CIN grade 2 or 3 and percentage referral to repeat colposcopy. Results: HPV testing at 12 months was sensitive (92.2%) for detection of CIN grade 2 or 3 with a referral rate to repeat colposcopy of 55.0%. Repeat semiannual cytology with referral to colposcopy at an ASCUS threshold demonstrated similar sensitivity (88.0%) but with a higher rate of referral to colposcopy (63.6%). Combining cytology and HPV testing did not increase sensitivity and hurt specificity. Baseline viral load and colposcopic impression were not helpful. Conclusion: The most efficient test for identifying women with CIN grade 2 or 3 after colposcopy might be an HPV test alone at 12 months. (Am J Obstet Gynecol 2003;188:1401-5.)</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Squamous Cell - diagnosis</subject><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Carcinoma, Squamous Cell - surgery</subject><subject>Carcinoma, Squamous Cell - virology</subject><subject>Cervical Intraepithelial Neoplasia - diagnosis</subject><subject>Cervical Intraepithelial Neoplasia - pathology</subject><subject>Cervical Intraepithelial Neoplasia - surgery</subject><subject>Cervical Intraepithelial Neoplasia - virology</subject><subject>Cervical intraepithelial neoplasia grade 1</subject><subject>cervix</subject><subject>clinical management</subject><subject>colposcopy</subject><subject>Colposcopy - standards</subject><subject>cytology</subject><subject>DNA, Viral - genetics</subject><subject>Female</subject><subject>Female genital diseases</subject><subject>Follow-Up Studies</subject><subject>Genital system. Mammary gland</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>human papillomavirus</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Non tumoral diseases</subject><subject>Papillomaviridae - genetics</subject><subject>Papillomaviridae - isolation & purification</subject><subject>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</subject><subject>Prospective Studies</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Sensitivity and Specificity</subject><subject>Triage</subject><subject>Uterine Cervical Neoplasms - diagnosis</subject><subject>Uterine Cervical Neoplasms - pathology</subject><subject>Uterine Cervical Neoplasms - surgery</subject><subject>Uterine Cervical Neoplasms - virology</subject><subject>Vaginal Smears</subject><issn>0002-9378</issn><issn>1097-6868</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkbGO1DAURS0EYmcHOmrkBioy2E7iJHSjhQWkFVBAHTn2y6yRE2dtZ0bp-Ae-EL6EN8yIbags2-ddX99LyDPONpzJ6vXgu41gLN8UpXxAVpw1VSZrWT8kK8aYyJq8qi_IZYzfj1vRiMfkgotaFI1sVuTXFx-T9m7yUftpoYMa1Q4GGBONKagEOwuR9j7Qg8dTGqCHEMDQg0231PlDtgvKAI13sxr8HKkdcQwmvAVnlaMOovVjpKhwO6M6ndRknfOD2tuA_NtP298_fuLzNtk9UJWWyWqc-yeowTkc7-k8GkgQBjvi89HuRtsjOWp4Q7c0HXy2gAp0Cj5OoP-KxTSb5Ql51CsX4el5XZNv1---Xn3Ibj6__3i1vcl0LouUCW5KLbUystSgOIeu7jUAZ7nsOl3LxnSlaoSWPC8MlHXNha4KKSsjGlbxLl-TlydddHA3Q0ztYOPRvBoB_9FWecFzieNr8uoEarQaMdB2CnZQYWk5a4-Vtlhpe6y0xUoRf37WnbsBzD187hCBF2dARUyuD5iJjfdc0QjBixo5eeIAU9hbCG3UFjA_YwMG1hpv_-_gDw19xfM</recordid><startdate>20030601</startdate><enddate>20030601</enddate><creator>Guido, Richard</creator><creator>Schiffman, Mark</creator><creator>Solomon, Diane</creator><creator>Burke, Louis</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20030601</creationdate><title>Postcolposcopy management strategies for women referred with low-grade squamous intraepithelial lesions or human papillomavirus DNA–positive atypical squamous cells of undetermined significance: A two-year prospective study</title><author>Guido, Richard ; Schiffman, Mark ; Solomon, Diane ; Burke, Louis</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c364t-21d5c6cad65cea11eb8fcee1036bbc869db5a92c6134de58812c74667d29071b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Carcinoma, Squamous Cell - diagnosis</topic><topic>Carcinoma, Squamous Cell - pathology</topic><topic>Carcinoma, Squamous Cell - surgery</topic><topic>Carcinoma, Squamous Cell - virology</topic><topic>Cervical Intraepithelial Neoplasia - diagnosis</topic><topic>Cervical Intraepithelial Neoplasia - pathology</topic><topic>Cervical Intraepithelial Neoplasia - surgery</topic><topic>Cervical Intraepithelial Neoplasia - virology</topic><topic>Cervical intraepithelial neoplasia grade 1</topic><topic>cervix</topic><topic>clinical management</topic><topic>colposcopy</topic><topic>Colposcopy - standards</topic><topic>cytology</topic><topic>DNA, Viral - genetics</topic><topic>Female</topic><topic>Female genital diseases</topic><topic>Follow-Up Studies</topic><topic>Genital system. Mammary gland</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>human papillomavirus</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Non tumoral diseases</topic><topic>Papillomaviridae - genetics</topic><topic>Papillomaviridae - isolation & purification</topic><topic>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</topic><topic>Prospective Studies</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Sensitivity and Specificity</topic><topic>Triage</topic><topic>Uterine Cervical Neoplasms - diagnosis</topic><topic>Uterine Cervical Neoplasms - pathology</topic><topic>Uterine Cervical Neoplasms - surgery</topic><topic>Uterine Cervical Neoplasms - virology</topic><topic>Vaginal Smears</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Guido, Richard</creatorcontrib><creatorcontrib>Schiffman, Mark</creatorcontrib><creatorcontrib>Solomon, Diane</creatorcontrib><creatorcontrib>Burke, Louis</creatorcontrib><creatorcontrib>for the ASCUS LSIL Triage Study (ALTS) Group</creatorcontrib><creatorcontrib>ASCUS LSIL Triage Study (ALTS) Group</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of obstetrics and gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Guido, Richard</au><au>Schiffman, Mark</au><au>Solomon, Diane</au><au>Burke, Louis</au><aucorp>for the ASCUS LSIL Triage Study (ALTS) Group</aucorp><aucorp>ASCUS LSIL Triage Study (ALTS) Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Postcolposcopy management strategies for women referred with low-grade squamous intraepithelial lesions or human papillomavirus DNA–positive atypical squamous cells of undetermined significance: A two-year prospective study</atitle><jtitle>American journal of obstetrics and gynecology</jtitle><addtitle>Am J Obstet Gynecol</addtitle><date>2003-06-01</date><risdate>2003</risdate><volume>188</volume><issue>6</issue><spage>1401</spage><epage>1405</epage><pages>1401-1405</pages><issn>0002-9378</issn><eissn>1097-6868</eissn><coden>AJOGAH</coden><abstract>Objective: This study was undertaken to compare postcolposcopy management strategies for women referred for low-grade squamous intraepithelial lesions (LSIL) or oncogenic human papillomavirus (HPV) DNA–positive atypical squamous cells of undetermined significance (ASCUS), with cervical intraepithelial neoplasia (CIN) grade 1 or less found at initial colposcopy. Study Design: A 2-year prospective follow-up of 1539 women was designed to assess the percentage sensitivity of different postcolposcopy management strategies to detect subsequent CIN grade 2 or 3 and percentage referral to repeat colposcopy. Results: HPV testing at 12 months was sensitive (92.2%) for detection of CIN grade 2 or 3 with a referral rate to repeat colposcopy of 55.0%. Repeat semiannual cytology with referral to colposcopy at an ASCUS threshold demonstrated similar sensitivity (88.0%) but with a higher rate of referral to colposcopy (63.6%). Combining cytology and HPV testing did not increase sensitivity and hurt specificity. Baseline viral load and colposcopic impression were not helpful. Conclusion: The most efficient test for identifying women with CIN grade 2 or 3 after colposcopy might be an HPV test alone at 12 months. (Am J Obstet Gynecol 2003;188:1401-5.)</abstract><cop>Philadelphia, PA</cop><pub>Mosby, Inc</pub><pmid>12824969</pmid><doi>10.1067/mob.2003.456</doi><tpages>5</tpages></addata></record> |
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| ispartof | American journal of obstetrics and gynecology, 2003-06, Vol.188 (6), p.1401-1405 |
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| subjects | Adolescent Adult Aged Biological and medical sciences Carcinoma, Squamous Cell - diagnosis Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - surgery Carcinoma, Squamous Cell - virology Cervical Intraepithelial Neoplasia - diagnosis Cervical Intraepithelial Neoplasia - pathology Cervical Intraepithelial Neoplasia - surgery Cervical Intraepithelial Neoplasia - virology Cervical intraepithelial neoplasia grade 1 cervix clinical management colposcopy Colposcopy - standards cytology DNA, Viral - genetics Female Female genital diseases Follow-Up Studies Genital system. Mammary gland Gynecology. Andrology. Obstetrics human papillomavirus Humans Investigative techniques, diagnostic techniques (general aspects) Medical sciences Middle Aged Neoplasm Staging Non tumoral diseases Papillomaviridae - genetics Papillomaviridae - isolation & purification Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques Prospective Studies Randomized Controlled Trials as Topic Sensitivity and Specificity Triage Uterine Cervical Neoplasms - diagnosis Uterine Cervical Neoplasms - pathology Uterine Cervical Neoplasms - surgery Uterine Cervical Neoplasms - virology Vaginal Smears |
| title | Postcolposcopy management strategies for women referred with low-grade squamous intraepithelial lesions or human papillomavirus DNA–positive atypical squamous cells of undetermined significance: A two-year prospective study |
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