Effect of High-Risk Human Papillomavirus but Normal Cytology at Test of Cure on Achieving Colposcopy Standards

Emmanouil Kalampokas, Judith Wilson, Mahalakshmi Gurumurthy, Margaret E. Cruickshank

Research output: Contribution to journalArticle

2 Citations (Scopus)
6 Downloads (Pure)

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.
Original languageEnglish
Pages (from-to)110-114
Number of pages5
JournalJournal of Lower Genital Tract Disease
Volume22
Issue number2
Early online date23 Feb 2018
DOIs
Publication statusPublished - 1 Apr 2018

Keywords

  • Test of cure
  • HPV positive
  • cytology negative
  • follow-up

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