Adherence to follow-up in women with cervical intraepithelial neoplasia grade 1

Srisuttayasathien, Manasawee; Manchana, Tarinee

doi:10.1016/j.tjog.2020.11.008

Cited by 8 publications

(7 citation statements)

References 15 publications

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“…The proportion of women who don't return for follow-up at one year following treatment for premalignant cervical lesions in this population of Ugandan women is much higher than that found in previous studies (21)(22)(23).That more than 7 in 10 women who underwent treatment for premalignant cervical lesions did not return for follow-up, is alarming. The effectiveness of screening in preventing cervical cancer lies in prompt diagnosis and treatment of premalignant cervical lesions (6, 12).…”

Section: Discussioncontrasting

confidence: 58%

High rate of loss to follow-up among patients undergoing treatment for premalignant cervical lesions at Mbarara Regional Referral Hospital, South Western Uganda; a retrospective cohort study

Kajabwangu,

Ssedyabane,

Tusubira

et al. 2023

Preprint

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Background For a cervical cancer control program to be effective in reducing incidence of the disease, there should be a high compliance to treatment and follow-up of the women diagnosed with precursor lesions. Screening programs in low-resource countries like Uganda are challenged by poor adherence to follow-up following treatment for premalignant cervical lesions. This study sought to describe the burden and factors associated with loss to follow-up among women undergoing treatment for premalignant cervical lesions at a tertiary hospital in south-western UgandaMethods This was a retrospective cohort study. We reviewed the registers at the Mbarara Regional Referral Hospital cervical cancer clinic for a period of four years from January 2017 to December 2020. Data was collected on; age, district of residence, diagnosis, date of diagnosis, date and type of initial treatment as well as date of follow up visit. We also captured data on whether patients returned on the scheduled follow up date or within three months after the scheduled follow up date. We defined loss to follow-up as failure to return for follow up either on the scheduled date or within three months after the scheduled date.Results Out of the 298 patients who underwent treatment for premalignant cervical lesions in the study period, 227(76.2%) did not return for follow-up at one year. At bivariate analysis, failure to attend the review visit at 6weeks predicted the loss to follow up at one year following treatment for premalignant lesions almost perfectly (RR = 2.84, 95% CI: 2.18–3.71, p-value < 0.001). Negative HIV serostatus and receiving thermocoagulation, slightly increased the risk of getting lost to follow-up while being more than 45years old reduced the odds. At multi-variate analysis, treatment with thermocoagulation (ARR = 1.21, 95% CI:1.07,1.36, p-value-0.03) was associated with loss to follow-up at one year.Conclusion The proportion of women who don’t return for follow-up at one year following treatment for premalignant cervical lesions at Mbarara regional referral hospital is very high. There is need to implement strategies that prompt patients to return for follow-up following treatment for premalignant cervical lesions.

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Section: Discussioncontrasting

confidence: 58%

High rate of loss to follow-up among patients undergoing treatment for premalignant cervical lesions at Mbarara Regional Referral Hospital, South Western Uganda; a retrospective cohort study

Kajabwangu,

Ssedyabane,

Tusubira

et al. 2023

Preprint

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“…Among women in our cohort who did not send back their Self-HPV, up to 9/22 (40.9%) and 17/31 (54.8%) of them did not come to their consultation at 6 and 12 months, respectively, suggesting their unwillingness to comply with the scheduled follow-up altogether. While Self-HPV may be used to circumvent the gynecological examination and to prevent loss at follow-up, these findings highlight the importance of targeted patient education about the benefits of follow-up after treatment for CIN ( Srisuttayasathien and Manchana, 2021 ). Further studies needed to assess reasons for non-attendance at follow-up.…”

Section: Discussionmentioning

confidence: 99%

HPV self-sampling in the follow-up of women after treatment of cervical intra-epithelial neoplasia: A prospective study in a high-income country

Viviano

Vassilakos

Meyer-Hamme

et al. 2021

Preventive Medicine Reports

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“…Cervical preneoplasia, also referred to as cervical intraepithelial neoplasia (CIN), is further categorized into CINI, CINII, and CINIII. CINI corresponding to low‐grade squamous intraepithelial lesions (LSIL) regresses spontaneously in approximately 80−90% of cases 11,12 . During this stage, the virus undergoes active replication, 13 and mild changes occur in cervical epithelial cells.…”

Section: Introductionmentioning

confidence: 99%

Human papillomavirus associated cervical lesion: pathogenesis and therapeutic interventions

Ye,

Zheng,

et al. 2023

MedComm

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Human papillomavirus (HPV) is the most prevalent sexually transmitted virus globally. Persistent high‐risk HPV infection can result in cervical precancerous lesions and cervical cancer, with 70% of cervical cancer cases associated with high‐risk types HPV16 and 18. HPV infection imposes a significant financial and psychological burden. Therefore, studying methods to eradicate HPV infection and halt the progression of precancerous lesions remains crucial. This review comprehensively explores the mechanisms underlying HPV‐related cervical lesions, including the viral life cycle, immune factors, epithelial cell malignant transformation, and host and environmental contributing factors. Additionally, we provide a comprehensive overview of treatment methods for HPV‐related cervical precancerous lesions and cervical cancer. Our focus is on immunotherapy, encompassing HPV therapeutic vaccines, immune checkpoint inhibitors, and advanced adoptive T cell therapy. Furthermore, we summarize the commonly employed drugs and other nonsurgical treatments currently utilized in clinical practice for managing HPV infection and associated cervical lesions. Gene editing technology is currently undergoing clinical research and, although not yet employed officially in clinical treatment of cervical lesions, numerous preclinical studies have substantiated its efficacy. Therefore, it holds promise as a precise treatment strategy for HPV‐related cervical lesions.

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Adherence to follow-up in women with cervical intraepithelial neoplasia grade 1

Cited by 8 publications

References 15 publications

High rate of loss to follow-up among patients undergoing treatment for premalignant cervical lesions at Mbarara Regional Referral Hospital, South Western Uganda; a retrospective cohort study

High rate of loss to follow-up among patients undergoing treatment for premalignant cervical lesions at Mbarara Regional Referral Hospital, South Western Uganda; a retrospective cohort study

HPV self-sampling in the follow-up of women after treatment of cervical intra-epithelial neoplasia: A prospective study in a high-income country

Human papillomavirus associated cervical lesion: pathogenesis and therapeutic interventions

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