Is there a role for colposcopy in the follow‐up of treated low grade squamous intraepithelial lesions?

Jones, S; Sykes, Peter; Pather, Selvan; Peddie, David

doi:10.1111/j.1479-828x.2004.00322.x

Cited by 2 publications

(3 citation statements)

References 12 publications

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“…Success rate after initial treatment was determined to be 95.6%. [3] In the present study, persistent disease was found in 38 of 240 patients, and progression was seen in 16.…”

Section: Discussionmentioning

confidence: 75%

“…Previous studies have shown that using merely colposcopy on follow-up has low sensitivity. [3] It has been shown that 70% of LSIL lesions regress on their own; however, 10% progress to HSIL. [11,12] Petry et al reported 30.2% CIN 3 and 1% cervical carcinoma in LSIL patients.…”

Section: Discussionmentioning

confidence: 99%

“…Physicians face various questions and complications, including an obligation to make a fast diagnosis, yet excessive intervention and overtreatment that can include colposcopic examination, cervical biopsy or biopsies, Human papillomavirus (HPV) tests and excisional surgery often only adds to the burden of both clinician and patient. [3] In addition, cases of carcinoma can be missed due to varying nature of diagnostic criteria in smear examinations, significantly high rate of false positives, significantly high rate of preneoplastic changes under cells with unknown importance to cytological examination, and follow-ups that are carried out with only cytological examination, colposcopic imaging or macroscopic imaging. [4] The present study sought to determine the significance of minor cytological abnormalities by clinically evaluating 8 years of LSIL-diagnosed smears from the hospital.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Significance of Cervical Low-Grade Squamous Intraepithelial Lesions: 8 Years’ Experience

Sakin¹

2017

South Clin Ist Euras

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Objective:The aim of the present study was to evaluate the follow-up results in patients who initially had cervical smear results showing low-grade squamous intraepithelial lesions (LSIL) in order to determine their histologic outcomes and develop a management guideline. Methods:A total of 240 non-pregnant women with LSIL in their cervical smears were evaluated with colposcopy, and colposcopically directed biopsies and endocervical sampling were done as indicated. Patients had follow-up smears every 3 to 4 months. Results:Of the 240 patients with LSIL, 108 patients (62.8%) were classified as having cervical intraepithelial neoplasia 1 (CIN 1), 28 (16.3%) cases had CIN 2, 12 patients (6.8%) had CIN 3, and 4 patients (2.3%) were diagnosed with invasive cervical carcinoma. At 12-month follow-up, persistence was observed in 38 (22%) cases, and progression to high-grade dysplasia was seen in 16 (9%) cases. Regression to normal smear was observed in 118 cases (68%). Conclusion:Since cervical minor abnormalities can change to low-grade lesions, high-grade lesions, or even cervical carcinoma, colposcopy was found to be an appropriate method for a correct diagnosis. Colposcopy in combination with smear was the ideal approach during follow-up.

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“…Success rate after initial treatment was determined to be 95.6%. [3] In the present study, persistent disease was found in 38 of 240 patients, and progression was seen in 16.…”

Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Significance of Cervical Low-Grade Squamous Intraepithelial Lesions: 8 Years’ Experience

Sakin¹

2017

South Clin Ist Euras

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Systematic screening for cervical cancer in Dakar region: prevalence and correlation with biological and socio-demographic parameters

Diouf

Diop

Diarra

et al. 2020

Infect Agents Cancer

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Background Cervical cancer is a major public health problem. In 2018, globally 569,847 cervical cancer were diagnosed and 311,000 deaths were projected due to this preventable disease. Worldwide, therefore, the cervical cancer disease ranks as the fourth most frequently diagnosed cancer and the fourth leading cause of cancer death in women in 2018. The high rate of dysplasia in Senegal and the absence of well-organized screening programs informed this study, which aims to determine the prevalence of cervical dysplasia and its relationship to biological and socio-demographic characteristics. Methods This study is based on 1000 conventional smears collected during routine cervical cancer screening at the Gaspard Camara Health Center and the Histology - Embryology and Cytogenetics Laboratory of the Cheikh Anta DIOP University in Dakar. The smears were read according to the Bethesda and Richart systems. However, all data were returned to the Bethesda system using the correspondence table between the different classifications of squamous cell lesions of the cervix. Some of the patients with abnormal smears had colposcopy and if necessary a biopsy. Other patients with low-grade lesions were recommended to have their smears resumed in 6 months or 1 year later. Results Cytological analysis was performed for 1000 patients aged 16 to 82 years (mean age = 41 ± 11.16). Among these, 176 patients had abnormal smears, 23 had Atypical Squamous Cells of Undetermined Significance (ASCUS), 143 had a low-grade lesion, 9 had a high-grade lesion and 1 had carcinoma. Among the remaining 822 patients, cytological analysis revealed no suspected malignant lesions, but 623 among them had dystrophy and 2 were unsatisfactory. Among patients with abnormal smears, 104 patients (23 ASCUS + 71 low grade + 9 high grade + 1 carcinoma) had performed colposcopy, 40 of whom had normal colposcopy and 64 had abnormalities. Sixty-four (64) biopsies were performed. Four (4) were not satisfactory. However, for 26/60 biopsies, the histology was normal, 21/60 had a low grade, 11 displayed a high grade and only 2 had carcinoma. Among the 176 patients with abnormal smears, 72 low-grade patients had undergone cytological examination 6 months to 1 year later to determine the persistence, regression or progression of low-grade dysplasia. During follow-up, persistence was observed in 25% (n = 18) of cases, progression to High-grade squamous intraepithelial lesion (HSIL) was detected in 2.78% (n = 2), while 72.22% (n = 52) of the patients experienced regression. Conclusion In this study, the prevalence of abnormal smear was 17.60% for cytology. Meanwhile, the Colposcopy and histology confirmed just 3.40%. These results underline the interest and need for a review of the discrepancies observed between pathologists.

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Is there a role for colposcopy in the follow‐up of treated low grade squamous intraepithelial lesions?

Cited by 2 publications

References 12 publications

Clinical Significance of Cervical Low-Grade Squamous Intraepithelial Lesions: 8 Years’ Experience

Clinical Significance of Cervical Low-Grade Squamous Intraepithelial Lesions: 8 Years’ Experience

Systematic screening for cervical cancer in Dakar region: prevalence and correlation with biological and socio-demographic parameters

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