Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

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

  • Ingkapairoj, Navakorn (Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University) ;
  • Luanratanakorn, Sanguanchoke (Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University) ;
  • Chumworathayi, Bandit (Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University) ;
  • Kietpeerakool, Chumnan (Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University) ;
  • Supoken, Amornrat (Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University)
  • Published : 2012.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

The aim of this study was to evaluate the outcomes of women with high-grade squamous intraepithelial lesion (HSIL) smears who had undergone the "see and treat" approach compared to those who underwent a conventional approach. The records of women with HSIL smears undergoing colposcopy at Srinagarind Hospital were reviewed. In those undergoing the conventional approach, the final histological diagnosis was made on the most severe histological results obtained after initial colposcopy. In the "see and treat" group, the final histological diagnosis was made on the examination of LEEP specimens obtained after initial colposcopy. Overtreatment in the see and treat group was defined as the LEEP specimens containing cervical intraepithelial neoplasia (CIN) 1 or less. During the study period, 302 women with HSIL underwent colposcopy. Twenty (6.6%) were nulliparous. One hundred and ninety-four (64.2%) underwent conventional management while the remaining 108 (35.8%) received the see and treat management. The prevalence of underlying high-grade lesions in women undergoing the conventional approach was significantly higher than that observed among women undergoing the see and treat approach (89.2% and 47.2%, respectively, P<0.001). The overtreatment rate in the see and treat group was 52.8%. Multivariate analysis revealed that only parity status was a statistically significant factor for predicting the overtreatment after undergoing the see and treat approach. In conclusion, the overtreatment rate among women undergoing see and treat in this study is notably high and therefore this approach should not be routinely practiced.

Keywords

References

  1. Aue-Aungkul A, Punyawatanasin S, Natprathan A, et al (2011). "See and treat" approach is appropriate in women with highgrade lesions on either cervical cytology or colposcopy. Asian Pac J Cancer Prev, 12, 1723-6.
  2. Balasubramani L, Orbell S, Hagger M, et al (2007). Do women with high-grade cervical intraepithelial neoplasia prefer a see and treat option in colposcopy? BJOG, 114, 39-45.
  3. Charoenkwan K, Srisomboon J, Siriaunkgul S, et al (2004). A "See and Treat" approach for high grade squamous intraepithelial lesion on cervical cytology. J Med Assoc Thai, 87, 865-8.
  4. Errington CA, Roberts M, Tindle P, et al (2006). Colposcopic management of high-grade referral smears: a retrospective audit supporting 'see and treat'? Cytopathology, 17, 339-47. https://doi.org/10.1111/j.1365-2303.2006.00395.x
  5. Holschneider CH, Ghosh K, Montz FJ (1999). See-and-treat in the management of high-grade squamous intraepithelial lesions of the cervix: a resource utilization analysis. Obstet Gynecol, 94, 377-85. https://doi.org/10.1016/S0029-7844(99)00337-3
  6. Kietpeerakool C, Cheewakriangkrai C, Suprasert P, et al (2009). Feasibility of the 'see and treat' approach in management of women with 'atypical squamous cell, cannot exclude high-grade squamous intraepithelial lesion' smears. J Obstet Gynaecol Res, 35, 507-13. https://doi.org/10.1111/j.1447-0756.2008.00992.x
  7. Kietpeerakool C, Srisomboon J (2010). Is the "see and treat" approach appropriate for management of women with abnormal cervical cytology in Thailand? Thai J Obstet Gynaecol, 18, 45-53.
  8. Kietpeerakool C, Srisomboon J, Khunamornpong S, et al (2007). How can the overtreatment rate of "see and treat" approach be reduced in women with high-grade squamous intraepithelial lesion on cervical cytology? Asian Pac J Cancer Prev, 8, 206-8.
  9. Kyrgiou M, Tsoumpou I, Vrekoussis T, et al (2006). The up to-date evidence on colposcopy practice and treatment of cervical intraepithelial neoplasia: the Cochrane colposcopy and cervical cytopathology collaborative group (C5 group) approach. Cancer Treat Rev, 32, 516-23. https://doi.org/10.1016/j.ctrv.2006.07.008
  10. Luesley D, Leeson S (2010). Colposcopy and Programme Management.Guidelines for the NHS Cervical Screening Programme. NHSCSP Publication, no. 20. Sheffield, UK:NHSCSP;2010.
  11. Numnum TM, Kirby TO, Leath CA, et al (2005). A prospective evaluation of "see and treat" in women with HSIL Pap smear results: is this an appropriate strategy? J Low Genit Tract Dis, 9, 2-6. https://doi.org/10.1097/00128360-200501000-00002
  12. Wright TC Jr, Massad LS, Dunton CJ, et al (2007). 2006 consensus guidelines for the management of women with abnormal cervical cancer screening tests. Am J Obstet Gynecol, 197, 346-55. https://doi.org/10.1016/j.ajog.2007.07.047
  13. Wright TC, Ronnett BM, Ferenczy A (2011). Precancerous lesions of the cervix. In Kurman RJ, Ellerson L H. Ellenson, Ronnett BM (Eds.), Blaustein's pathology of the female genital tract (sixth ed). Baltimore: Springer.pp.193-254

Cited by

  1. Histopathological Outcomes of Women with Abnormal Cervical Cytology: a Review of Literature in Thailand vol.15, pp.16, 2014, https://doi.org/10.7314/APJCP.2014.15.16.6489
  2. Cervical Pathology in High-Risk Human Papillomavirus-Positive, Cytologically Normal Women vol.15, pp.18, 2014, https://doi.org/10.7314/APJCP.2014.15.18.7977
  3. See-and-Treat Approach to Cervical Intraepithelial Lesions in HRH Princess Maha Chakri Sirindhorn Medical Center vol.15, pp.8, 2014, https://doi.org/10.7314/APJCP.2014.15.8.3483
  4. Evidence supporting see-and-treat management of cervical intraepithelial neoplasia: a systematic review and meta-analysis vol.123, pp.1, 2015, https://doi.org/10.1111/1471-0528.13530
  5. Post-Loop Electrosurgical Excision Procedure Complications in Srinagarind Hospital vol.17, pp.4, 2016, https://doi.org/10.7314/APJCP.2016.17.4.2211
  6. Clinical analysis of cervical intraepithelial neoplasia with vaginal intraepithelial neoplasia vol.96, pp.17, 2017, https://doi.org/10.1097/MD.0000000000006700
  7. Abnormal Pap Smear and Diagnosis of High-Grade Vaginal Intraepithelial Neoplasia vol.94, pp.42, 2015, https://doi.org/10.1097/MD.0000000000001827