Association between Colposcopic Findings and Histology in Cervical Lesions: The Significance of the Size of the Lesion

Kierkegaard, Ole; Byrjalsen, Carsten; Hansen, Kristen; Frandsen, Kristian H.; Frydenberg, Morten

doi:10.1006/gyno.1995.1100

Cited by 50 publications

(44 citation statements)

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“…The overall sensitivity of differential colposcopy without biopsy was reported to be 83.6 % [3]. Another study reported a correlation of 88.3 % within one histological grade [4]. Other studies have also investigated the correlation between histological assessment of biopsy findings and the final histological result after conization.…”

Section: Accuracy Of Colposcopically Guided Diagnostic Methods For Thmentioning

confidence: 99%

Accuracy of Colposcopically Guided Diagnostic Methods for the Detection of Cervical Intraepithelial Neoplasia

Müller

Soergel

Hillemanns

et al. 2016

Geburtshilfe Frauenheilkd

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!Introduction: Many factors can affect the accuracy of colposcopically guided biopsy, endocervical curettage (ECC) and differential cytology, all of which are standard, minimally invasive procedures used to detect cervical intraepithelial neoplasia. Method: All conizations carried out between 2007 and 2013 in the gynecological department of Hannover Medical School were retrospectively reviewed. The agreement between colposcopic diagnosis and histology was evaluated retrospectively. The analysis included 593 complete datasets out of a total of 717 cases treated. Results: The overall agreement was 85.5 %; the accuracy was significantly higher (p = 0.029) when three biopsy specimens were taken rather than just one. The agreement between diagnosis and histological findings from conization was highest for women < 30 years (90.7%) and lowest for women > 50 years (72.1%; p = 0.008). The agreement between preoperative differential cytology and histology results after conization was 86.7 % and improved as patient age increased (p = 0.035). The agreement between ECC findings and the results of conization was only 49.1 % irrespective of patient age, transformation zone or the patientʼs menopausal status. Conclusion: The accuracy of colposcopically guided biopsy appears to increase when three biopsy specimens are taken and is particularly high for younger patients. Differential cytology was also found to be highly accurate and is particularly useful for patients aged more than 50 years. The accuracy of ECC was significantly lower; however ECC can provide important additional information in selected cases.

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Section: Accuracy Of Colposcopically Guided Diagnostic Methods For Thmentioning

confidence: 99%

Accuracy of Colposcopically Guided Diagnostic Methods for the Detection of Cervical Intraepithelial Neoplasia

Müller

Soergel

Hillemanns

et al. 2016

Geburtshilfe Frauenheilkd

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“…Also, the procedure is performed to assess the results of a treatment or other disturbances: cervicitis, polyps, cervical warts, genital warts, bleeding, etc. However, these techniques might have been expected to contribute toward managing women with abnormal cytology [1,2].…”

Section: Definition and Why It Is Performedmentioning

confidence: 99%

“…These guidelines have greatly affected the optimal approach to hysterectomy in women with risks for cancer [2,6,7].…”

Section: Precancerous Changes Confirmed After Colposcopymentioning

confidence: 99%

“…We can stop the growth of cancer development by using colposcopy to confirm whether it is cervical intraepithelial neoplasia or cancer [1,2,3,8].…”

Section: Cervical Cancer Risk Is Attributed To Human Papillomavirus (mentioning

confidence: 99%

“…Thus, smaller lesions are known to cause more false-negative cervical smears than larger lesions [1,2,6,8].…”

Section: Colposcopy As a Diagnostic Screening Tool And Gathering Inmentioning

confidence: 99%

See 2 more Smart Citations

Colposcopic Assessment Among Women with Lower Genital Tract Pathology

Ancuta¹,

Sofroni²,

Ancuţa³

et al. 2017

Colposcopy and Cervical Pathology

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A broad spectrum of conditions classically requires a colposcopic assessment for either diagnostic or treatment means, including atypical changes in the cervix-vagina and vulva, abnormal Pap tests, cervicitis, polyps, cervical warts, genital warts, and bleeding. Although the procedure is commonly considered as criteria for the management of cervical cancer, the sensitivity of colposcopy is quite limited as its ability to discriminate among dysplasia and microinvasive carcinoma is difficult. Most professional societies and international health organizations have already released guidelines and recommendation for the management for woman with abnormal cervical pathology (e.g., cervical intraepithelial neoplasia and cervical cancer); only women with positive human papillomavirus (HPV) tests, low-grade squamous intraepithelial lesion (LSIL), or severe cytology have clear indication for referral to a colposcopic evaluation. While most guidelines recommend colposcopy for any abnormal cytology or any positive HPV test, others apply only for woman with two consecutive unsatisfactory Pap tests or for those with some abnormalities. In conclusion, cervical cancer risk remains high; thus, the potential benefit of colposcopy examination should be balanced against the risk.

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Preterm Birth Following Active Surveillance vs Loop Excision for Cervical Intraepithelial Neoplasia Grade 2

Lycke,

Kahlert,

Eriksen

et al. 2024

JAMA Netw Open

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ImportanceActive surveillance for cervical intraepithelial neoplasia grade 2 (CIN2) is being implemented in many high-income countries due to the association of excisional treatment with preterm birth. However, it is unknown whether active surveillance results in lower risk of preterm birth given that cervical dysplasia itself is associated with higher risk of preterm birth.ObjectiveTo compare the preterm birth risk between women with CIN2 undergoing active surveillance or immediate loop electrosurgical excision procedure (LEEP).Design, Setting, and ParticipantsThis historical population-based cohort study included women with a first-time diagnosis of CIN2 and a subsequent singleton birth from 1998 to 2018 in Denmark. Women with prior CIN grade 3 or greater or LEEP were excluded. Data were collected from 4 Danish health care registries. Analyses were conducted from October 2022 to June 2023.ExposureWomen were categorized into active surveillance (cervical biopsy and/or cytology) or immediate LEEP based on their first cervical sample after CIN2 diagnosis. The active surveillance group was further subdivided based on whether a delayed LEEP was performed within 28 months from CIN2 diagnosis.Main Outcomes and MeasuresRisk of preterm birth (&lt;37 + 0 weeks) was assessed and relative risks (RRs) were calculated using modified Poisson regression. Analyses used inverse probability treatment weighting of the propensity scores to adjust for age, parity, calendar year, index cytology, and smoking.ResultsA total of 10 537 women with CIN2 and a singleton birth were identified; 4430 (42%) underwent active surveillance and 6107 (58%) were treated with immediate LEEP. For both groups, most were aged 23 to 29 years at CIN2 diagnosis (3125 [70%] and 3907 [64%], respectively). Overall, 869 births (8.2%) were preterm. The risk of preterm birth was comparable between active surveillance and immediate LEEP (RR, 1.03; 95% CI, 0.90-1.18). However, for women undergoing delayed LEEP after active surveillance (1539 of the active surveillance group [35%]), the risk of preterm birth was higher than for women treated with immediate LEEP (RR, 1.29; 95% CI, 1.08-1.55).Conclusions and relevanceIn this cohort study of women with CIN2, the risk of preterm birth was comparable between active surveillance and immediate LEEP. However, delayed LEEP was associated with 30% higher risk of preterm birth than immediate LEEP. Thus, risk stratification at CIN2 diagnosis is important to identify women with increased risk of delayed LEEP.

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Association between Colposcopic Findings and Histology in Cervical Lesions: The Significance of the Size of the Lesion

Cited by 50 publications

References 0 publications

Accuracy of Colposcopically Guided Diagnostic Methods for the Detection of Cervical Intraepithelial Neoplasia

Accuracy of Colposcopically Guided Diagnostic Methods for the Detection of Cervical Intraepithelial Neoplasia

Colposcopic Assessment Among Women with Lower Genital Tract Pathology

Preterm Birth Following Active Surveillance vs Loop Excision for Cervical Intraepithelial Neoplasia Grade 2

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