Does experience in colposcopy improve identification of high grade abnormalities?

Bekkers, Ruud L.M.; Nieuwenhof, H.P. van de; Neesham, Deborah; Hendriks, Jan H. C. L.; Tan, Jeff; Quinn, Michael

doi:10.1016/j.ejogrb.2008.07.007

Cited by 39 publications

(32 citation statements)

References 13 publications

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“…It requires experience to acquire expertise in this procedure but even then there is only moderate correlation between colposcopic assessment and the final histological diagnosis [3,4]. New evidence in cervical cancer prevention strategies was being translated in a supplement of the European guidelines for Quality Assurance in Cervical Cancer Screening [1], but colposcopic practice was not addressed in detail.…”

Section: Discussionmentioning

confidence: 98%

“…Generally, if a CIN2 or worse (CIN2+) is found the woman receives treatment. Despite the central role of colposcopy in detecting CIN2 +, it has been suggested that it can miss 30-55% of high-grade lesions [2][3][4][5][6]. In a study investigating women with atypical cells of undetermined significance (ASC-US) cytology and CIN3 or invasive cervical cancer (ICC), it was found that gains in detecting cervical precancer can be obtained by increasing the number of lesion-directed biopsies from one to two [6].…”

mentioning

confidence: 95%

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The increased detection of cervical intraepithelial neoplasia when using a second biopsy at colposcopy

Marel¹,

Baars²,

Rodríguez³

et al. 2014

Gynecologic Oncology

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Section: Discussionmentioning

confidence: 98%

mentioning

confidence: 95%

The increased detection of cervical intraepithelial neoplasia when using a second biopsy at colposcopy

Marel¹,

Baars²,

Rodríguez³

et al. 2014

Gynecologic Oncology

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“…However, a previous study from van Baars et al confirmed that the methylation status of the cervical cytology sample represents the methylation status of the worst lesion present on the cervix when taking biopsies of all lesions detected during colposcopy together with a random biopsy of normal appearing tissue. 9 Sensitivity of colposcopy for the detection of ≥HSIL/CIN2 is between 50% and 70% [20][21][22][23] and methylation positivity on cytology in the absence of high-grade disease on biopsy could possibly originate from a high-grade lesion that was missed on colposcopy.…”

Section: Discussionmentioning

confidence: 99%

Expression of p16 and HPV E4 on biopsy samples and methylation of FAM19A4 and miR124‐2 on cervical cytology samples in the classification of cervical squamous intraepithelial lesions

et al. 2020

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The decision to treat a cervical squamous intraepithelial lesion (SIL) by loop electrosurgical excision procedure (LEEP) relies heavily on a colposcopy‐directed biopsy showing high‐grade (H)SIL. Diagnosis is often supported by p16, an immunohistochemical (IHC) biomarker of high‐risk (hr)HPV E7 gene activity. Additional potential markers include methylation of tumor suppressor genes FAM19A4/miR124‐2 in cervical cytology for advanced transforming HSIL and the IHC marker HPV E4 for productive, potentially regressing lesions. In 318 women referred for colposcopy, we investigated the relationship between staining patterns of p16 and E4 IHC in the worst biopsy, and the relation of these to FAM19A4/miR124‐2 methylation status in cytology. E4‐positive staining decreased with increasing SIL/CIN grade from 41% in LSIL to 3% in HSIL/CIN3. E4 positivity increased with grade of p16 when p16 expression was limited to the lower two third of the epithelium (r = 0.378), but fell with expression over. Loss of E4 expression in the worst lesion was associated with the methylation of FAM19A4/miR124‐2. We also examined whether these biomarkers can predict the histological outcome of the LEEP biopsy in a subgroup of 119 who underwent LEEP treatment. About 85% of women with ≥lower two third p16 staining/E4‐negative HSIL biopsies and 65% with limited p16 staining/E4‐positive HSIL biopsies had ≥HSIL in the LEEP specimen (P = .025). p16 expression in a biopsy is related both to viral production and transformation, while decreased E4 expression relates to methylation, indicating advanced HSIL. p16 expression in ≥2/3 of the epithelium and absent E4 indicate likely HSIL on a subsequent LEEP specimen.

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“…Women with a cytological diagnosis worse than borderline or mild dyskaryosis (>BMD) or a persistent BMD are referred to a gynaecologist [2]. The current screening programme suffers from a relatively low attendance rate (66%) [3], a low sensitivity of cytology (60-70%) [4][5][6] and a low sensitivity of colposcopy (55%) [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

The diagnostic process of cervical cancer; areas of good practice, and windows of opportunity

Zaal

Wilde

Duk

et al. 2015

Gynecologic Oncology

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Does experience in colposcopy improve identification of high grade abnormalities?

Cited by 39 publications

References 13 publications

The increased detection of cervical intraepithelial neoplasia when using a second biopsy at colposcopy

The increased detection of cervical intraepithelial neoplasia when using a second biopsy at colposcopy

Expression of p16 and HPV E4 on biopsy samples and methylation of FAM19A4 and miR124‐2 on cervical cytology samples in the classification of cervical squamous intraepithelial lesions

The diagnostic process of cervical cancer; areas of good practice, and windows of opportunity

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