Incidences of Cervical Intraepithelial Neoplasia 2-3 or Cancer Pathologic Diagnoses in Patients with a High Grade Squamous Intraepithelial Lesion Pap Smear Attending a Colposcopy Clinic at Srinagarind Hospital

Background: To evaluate the overtreatment rate with the see and treat approach in the management of women with abnormal cervical cytology. Materials and Methods: A retrospective review of patients with abnormal cervical cytology who underwent S&T at MSMC between January 2008 and December 2012 was conducted. Loop electrosurgical excision procedure (LEEP), histological results, cytology and colposcopic impression were analyzed to evaluate overtreatment rate, cyto-histologic correlation and related factors. Results: Average age of S&T cases was 42 years. Ninety seven percents were referred from affiliated health care providers. The study revealed 83.2% patients had HSIL or higher from cervical cytology. Correlation between HSIL and final histology was relatively low at 75% compared to other studies. Overtreatment rate was 28%. Conclusions: S&T was done in 197 patients in a tertiary care health facility with patient satisfaction. Overtreatment occurred, but the rate can be reduced with appropriate recommendations. HSIL Pap smears should be reexamined before S&T while low grade and lesser colposcopic impression groups should obtain conventional colposcopic approach for patient future reproductive benefit.

Section: Discussionmentioning

confidence: 76%

See-and-Treat Approach to Cervical Intraepithelial Lesions in HRH Princess Maha Chakri Sirindhorn Medical Center

Srisuwan

Hamontri²,

Kongsomboon³

et al. 2014

“…As compared to the results from areas with a low incidence of cervical cancer, Thai women with abnormal cervical cytology carry a higher risk of encountering significant cervical lesion (Kietpeerakool Buasorn Supho, Amornrat Supoken, Pilaiwan Kleebkaew, Chumnan Kietpeerakool* et al, 2009;Poomtavorn et al, 2011;Aue-Aungkul et al, 2011;Ingkapairoj et al, 2012). This finding emphasizes the potential need of particular management of abnormal cervical cancer screening results among Thai women.…”

Section: Introductionmentioning

confidence: 74%

Cervical Pathology in High-Risk Human Papillomavirus-Positive, Cytologically Normal Women

Supho

Supoken²,

Kleebkaew³

et al. 2014

Self Cite

This study was undertaken to evaluate the prevalence of significant cervical pathology among women who are high-risk human papillomavirus (HR-HPV)-positive/cytology negative, the most common combination of positive co-tests. The records of 244 women HR-HPV-positive/cytology-negative who had undergone colposcopy at Srinagarind Hospital, Khon Kaen University during January 2010 and April 2014 were reviewed. Mean age was 46.4 years. Of these 224 women, 75 were positive for HPV types 16/18 (33.5%) and 123 were positive for non-16/18 types (54.9%). HR-HPV was not genotyped in the remaining 26 women (11.6%). Prevalence of significant lesions for the entire cohort was 2.4%, and 2.6% and 3.3%, respectively, for those with HPV 16/18 and other oncogenic HPV types. One woman with HPV 16/18 (1.3%) had invasive cervical cancer. Multiparous women were more likely to be infected with HPV 16/18 compared to nulliparous women (36.3% versus 17.6%, respectively). In conclusion, the prevalence of significant cervical lesion among our study population was 2.4%. Multiparous women were more likely to be infected with HPV 16/18 compared to nulliparous women.

“…Previous reported incidence of precancerous lesion and invasive cancer among population resided in low cervical cancer incidence areas ranges 60%-80% and 1-3%, respectively (Jones and Davey, 2000;Massad et al, 2001;Szurkus and Harrison, 2003;Berdichevsky et al, 2004;Boman et al, 2004;Numnum et al, 2005;Chute et al, 2006;Sadan et al, 2007). In Thailand, although incidence of CIN2-3 and AIS in women with HSIL smears (62% to 74%) paralleled those reports of other populations, the incidences of underlying invasive disease were remarkably higher ranging from 7.9% to 25.8% (Kantathavorn et al, 2006;Boonlikit, 2008;Aue-Aungkul et al, 2011;Sripipattanakul, 2011;Ingkapairoj et al, 2012;Kingnate, et al, 2014) (Table 2). Therefore, intensive evaluation of Thai women with HSIL smears is mandatory in order to exclude occult invasive lesion.…”

Section: High-grade Squamous Intraepithelial Lesionmentioning

confidence: 96%

Histopathological Outcomes of Women with Abnormal Cervical Cytology: a Review of Literature in Thailand

Kietpeerakool¹,

Tangjitgamol²,

Srisomboon³

2014

Self Cite

Asian Pac J Cancer Prev, 15 (16), 6489-6494 IntroductionCervical cancer remains the major health problem in Thailand and many other developing countries. This is mainly because of failure to initiate or sustain effective screening strategy. In recent population-based cancer registries, the highest incidence of cervical cancer in Thailand was noted in Chiang Mai with an average agestandardized incidence rate (ASR) of 28.9 per 100000, followed by Lampang (ASR, 22.4) and Bangkok (ASR, 20.9) (Moore et al., 2010).Although high-risk Human Papillomavirus (HR-HPV) test and HPV genotyping have certain role in cervical cancer screening nowadays, these tests are not widely available in developing countries. Cervical cytology is still the principal screening method. Subsequent management of abnormal cervical cytology to detect underlying cervical lesions is also important. Generally, management of abnormal cervical cytology depends on the risk of encountering high-grade cervical disease. However, the risks of high-grade cervical disease encountered in abnormal cervical cytology may vary among different regions of the world and across the country. Therefore, information regarding the incidence of significant cervical disease from different areas or populations is crucial for designing and implementing area-specific management approach. This review was conducted to evaluate the incidence of high-grade cervical diseases among Thai AbstractCervical cytology remains the principal screening method to detect pre-invasive and invasive cervical lesions. Management of abnormal cervical cytology depends on the risk of encountering a significant cervical lesion or high-grade cervical disease. These risks may vary in different areas across the country. Thus, determining the rate of significant cervical lesion associated with each type of abnormal cervical cytology in each area is of critical importance for designing area-specific management approach. This review was conducted to evaluate the rate of high-grade cervical disease among Thai women with abnormal cervical cytology. A relatively high incidence of underlying significant lesions including invasive disease was demonstrated even in those having only minimal smear abnormality. This baseline information is crucial and must be taken into consideration in management of women with abnormal cytological screening to achieve the goals of comprehensive cervical cancer control in Thailand.