Squamocolumnar junction visibility, age, and implications for cervical cancer screening programs

Desai, Kanan T.; Hansen, Natasha; Rodriguez, Ana-Cecilia; Befano, Brian; Egemen, Didem; Gage, Julia C.; Wentzensen, Nicolas; Lopez, Catya; Jeronimo, Jose; de Sanjose, Silvia; Schiffman, Mark

doi:10.1016/j.ypmed.2024.107881

Preventive Medicine

2024

DOI: 10.1016/j.ypmed.2024.107881

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Squamocolumnar junction visibility, age, and implications for cervical cancer screening programs

Kanan T. Desai,

Natasha Hansen,

Ana-Cecilia Rodriguez

et al.

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2024

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Cited by 4 publications

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Understanding the age-related epithelial shifts at the uterine cervix and the area of risk for squamous cell cervical cancer

Reich,

Regauer

2024

Preventive Medicine

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Understanding the age-related epithelial shifts at the uterine cervix and the area of risk for squamous cell cervical cancer

Reich,

Regauer

2024

Preventive Medicine

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Evaluation of Endocervical Curettage in Colposcopy in the Turkish Cervical Cancer Screening Program

Akgor,

Ozgul,

Gunes

et al. 2024

JCM

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Background/Objectives: To investigate the risk factors for CIN2+ lesions (cervical intraepithelial neoplasia 3 or worse) in endocervical curettage (ECC) and to evaluate the relationship between the addition of ECC to punch biopsy in terms of the yield of CIN2+ lesions. Methods: Between February 2018 and 2019, data on colposcopy results from 11,944 patients were gathered from the Cancer Department of the Turkish Ministry of Health across the country. A total of 6370 women whom were referred to colposcopy were included in this study. Risk factors were identified using both univariate and multivariate logistic analyses. Results: The median age was 42 years old (range, 30–65). ASC-H (atypical squamous cells-suggestive of high-grade squamous intraepithelial lesion)/HSIL (high-grade intraepithelial lesion) cytology (OR 7.648 95% CI (3.933–14.871)) and HPV (human papillomavirus)-16/18 infection (OR 2.541 95% CI (1.788–3.611)) were identified as risk factors for having CIN2+ lesions. CIN2+ diagnostic yield by ECC is only 1.2% all patients. CIN2+ diagnostic yield by punch biopsy and ECC are 9.7% and 6% of patients, respectively. A higher CIN2+ yield by ECC was observed with increasing age. Among cytology groups, ASC-H/HSIL has highest CIN2+ yield by ECC. Finally, in patients with incomplete visualization of the squamocolumnar junction (SCJ), ECC yields approximately twice as many CIN2+ lesions. Conclusions: ECC should be considered in cases of advanced patient age and in situations where the SCJ is not routinely visualized. In addition, evaluation of the endocervical canal is necessary in HPV-positive cases infected with HPV-16/18 types and in cases infected with HPV of any type but with cytological abnormalities.

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Impact of Excision Type, Cone Volume, and Dimensions on Persistence/Recurrence of Cervical Intraepithelial Neoplasia 2–3

Medina Bueno,

Fernández-Montolí,

Heydari

et al. 2024

Life

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The objective of this study was to evaluate the relationship between the excision type and the persistence/recurrence of CIN2–3. A total of 227 women with CIN2–3 who were treated with LLETZ were evaluated. The types of excision according to the IFCPC 2011, volume, cone dimensions, margins of resection, post-cone high-risk human papillomavirus (HR-HPV) status, and viral load were studied. The time to recurrence was assessed using Kaplan–Meier curves. Persistent/recurrent CIN2–3 was found in 12 cases (5.2%). Type 1 excision was performed in 107 patients, with 7 recurrences (6.5%); type 2 excision in 74 patients, with 4 recurrences (5.4%); and type 3 excision in 46 patients, with 1 recurrence (2.1%). The percentage of clear margins in type 1 excisions was 44.9%, that in type 2 excisions was 59.5%, and that in type 3 excisions was 69.6% (p = 0.008). Type 1 excision was associated with 28.5% post-LLETZ HR-HPV positivity, that in type 2 reached 20.6%, and that in type 3 reached 11.4%; this difference was non-significant (p = 0.24). (4) Conclusions: Type 3 excision was associated with a larger proportion of clear margins and lower post-cone HR-HPV positivity, with a lower incidence of the persistence/recurrence of CIN2–3.

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Squamocolumnar junction visibility, age, and implications for cervical cancer screening programs

Cited by 4 publications

References 13 publications

Understanding the age-related epithelial shifts at the uterine cervix and the area of risk for squamous cell cervical cancer

Understanding the age-related epithelial shifts at the uterine cervix and the area of risk for squamous cell cervical cancer

Evaluation of Endocervical Curettage in Colposcopy in the Turkish Cervical Cancer Screening Program

Impact of Excision Type, Cone Volume, and Dimensions on Persistence/Recurrence of Cervical Intraepithelial Neoplasia 2–3

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