Abstract
Objective: In U.K., Test of Cure (ToC) after treatment of any grade of CIN incorporates high risk-HPV (Hr-HPV) test and cytology at 6 months follow-up. Our aim was to determine the rate of recurrent Cervical Intraepithelial Neoplasia (CIN) in women who are Hr-HPV positive and cytology negative and explore possible associated risk factors.
Methods: A retrospective observational cohort study was performed of women treated for any grade CIN between 2010-2015 from a regional population who were Hr-HPV positive and cytology negative at first follow-up.
Results: 2729 women were identified as treated for any grade CIN and 213 (7.8%) were re-referred to colposcopy having Hr-HPV positive test and negative cytology at ToC. Their mean age was 31.56 years (range 19-62 years). The mean time of follow-up per woman was 30.50 months (2-63 months). At colposcopy, 171 (80.3%) had colposcopy examination only and 42 (19.7%) women had a biopsy. 24 (11.3%) cases of CIN were identified of which 4 (1.9%) were CIN2/3. 11 (5.2%) women in total had a repeat treatment. 5 (2.3%) women had biopsy proven CIN2/3 within 12 months post-treatment. No cases of CIN3+ after negative colposcopy were identified during the follow-up period.
Conclusions: The incorporation of Hr-HPV testing yielded a very small number of women with residual CIN within 12 months of treatment. Our results suggest that women who are Hr-HPV positive and cytology negative post-treatment of CIN with normal adequate colposcopy could be discharged to routine recall if confirmed by larger national data.
Methods: A retrospective observational cohort study was performed of women treated for any grade CIN between 2010-2015 from a regional population who were Hr-HPV positive and cytology negative at first follow-up.
Results: 2729 women were identified as treated for any grade CIN and 213 (7.8%) were re-referred to colposcopy having Hr-HPV positive test and negative cytology at ToC. Their mean age was 31.56 years (range 19-62 years). The mean time of follow-up per woman was 30.50 months (2-63 months). At colposcopy, 171 (80.3%) had colposcopy examination only and 42 (19.7%) women had a biopsy. 24 (11.3%) cases of CIN were identified of which 4 (1.9%) were CIN2/3. 11 (5.2%) women in total had a repeat treatment. 5 (2.3%) women had biopsy proven CIN2/3 within 12 months post-treatment. No cases of CIN3+ after negative colposcopy were identified during the follow-up period.
Conclusions: The incorporation of Hr-HPV testing yielded a very small number of women with residual CIN within 12 months of treatment. Our results suggest that women who are Hr-HPV positive and cytology negative post-treatment of CIN with normal adequate colposcopy could be discharged to routine recall if confirmed by larger national data.
| Original language | English |
|---|---|
| Pages (from-to) | 110-114 |
| Number of pages | 5 |
| Journal | Journal of Lower Genital Tract Disease |
| Volume | 22 |
| Issue number | 2 |
| Early online date | 23 Feb 2018 |
| DOIs | |
| Publication status | Published - 1 Apr 2018 |
Bibliographical note
Acknowledgements: We thank Sister Christine Godley for helping with data collection.Declaration of Interests: The authors have no conflicts of interest to declare.
Funding: None.
Keywords
- Test of cure
- HPV positive
- cytology negative
- follow-up