The Colposcopic Examination

Frank, Joseph F.

doi:10.1016/j.jmwh.2008.04.001

Cited by 8 publications

(4 citation statements)

References 39 publications

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“…Concordant with other reports (36), in the present study, the patients near or in the post-menopausal age group, i.e. 45 or above, significantly more often had the finding of transition zone 3, TZ3, on colposcopy compared to the women below age 45.…”

Section: Discussionsupporting

confidence: 92%

Age, margin status, high‑risk human papillomavirus and cytology independently predict recurrent high‑grade cervical intraepithelial neoplasia up to 6 years after treatment

et al. 2021

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The present study aimed to identify the factors that independently contribute to disease recurrence among women first-time treated for high-grade cervical intraepithelial neoplasia (CIN) during 4-6 years of follow-up. Overall, 529 of 530 eligible patients participated; these patients all attended a 1st follow-up appointment ~6 months post-conization, at which time high-risk human-papillomavirus (HPV) testing, liquid-based cytology and colposcopy were performed. Full data on margin excision status, other aspects of initial treatment and comorbidity were obtained. At least one subsequent follow-up was attended by 88% of patients. A total of 22 recurrent cases were detected during follow-up. Detected recurrence was the outcome of focus for multiple logistic regression analysis, with odds ratios (OR) and 95% confidence intervals (CI) computed. Four significant independent risk factors were identified: Age 45 years or above (OR=3.5, 95% CI=1.3-9.9), one or both unclear or uncertain margins (OR=5.3, 95% CI=2.0-14.2), positive HPV at 1st follow-up (OR=5.8, 95% CI=2.0-16.8), and abnormal cytology at 1st follow-up (OR=3.9, 95% CI=1.4-11.0). Bivariate analysis revealed that persistent HPV positivity was associated with recurrence (P<0.01). These findings indicated that incomplete excision of the CIN lesion may warrant more intensive subsequent screening, regardless of early post-conization HPV findings. Although early post-conization positive HPV was a powerful, independent predictor of recurrent high-grade CIN, over one-third of the patients with detected recurrence had a negative early post-conization HPV finding. These patients returned for routine screening, at which time, in most cases, HPV status was positive, thus indicating the need for repeated HPV evaluation. Especially during the on-going pandemic, home vaginal self-sampling is recommended. Particular attention is required for women aged ≥45 years. In addition, although not statistically significant, relevant comorbidities, especially autoimmune conditions, warrant consideration in clinical decision-making. Women who have been treated for high-grade CIN are at risk for recurrent disease and progression to cervical cancer; therefore, they require careful, individualized follow-up to avoid these adverse consequences.

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Section: Discussionsupporting

confidence: 92%

Age, margin status, high‑risk human papillomavirus and cytology independently predict recurrent high‑grade cervical intraepithelial neoplasia up to 6 years after treatment

et al. 2021

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“…[6] Satisfactory colposcopy is determined by the visualization of the squamocolumnar junction (SCJ), as cervical carcinoma 7 frequently originates from this location and the borders of any visible lesions. [7,8] The SCJ location is proximal to the ectocervix in younger women but is displaced higher in the endocervical canal, known as the type 3 transformation zone (TZ3), with increased age, trauma, surgery, and stenosis. [8][9][10] During the colposcopic evaluation, SCJ must be seen completely; otherwise, unsatisfactory colposcopy is determined, and it is generally seen in 20% of cases, endocervical sampling (endocervical brush [ECB]/endocervical curettage [ECC]) is required.…”

Section: Introductionmentioning

confidence: 99%

Comparison of endocervical curettage and endocervical brush during unsatisfactory colposcopy for endocervical sampling in human papillomaviruses positive women

Şenyuva¹

2023

Zeynep Kamil Med J

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Objective: Comparison of endocervical curettage (ECC) and endocervical brush (ECB) in women with human papillomaviruses (HPV) positive who had unsatisfactory colposcopy for endocervical sampling.Material and Methods: Women who underwent ECC and ECB during an unsatisfactory colposcopy were retrospectively investigated. The results were classified as normal, inadequate, low, and high-grade lesions for compiling the two methods.Results: In the 44 cases, the mean age was 45.75±9.71; seven of the 44 cases were low-risk HPV, while 37 were high-risk HPV. Normal results were reported in 19.4% of ECB and 32.8% of ECC (p>0.05). Unsatisfactory results were observed in 56.3% of ECB and 37.5% of ECC (p>0.05). Low-grade epithelial abnormalities were detected more in the ECB (p=0.001). ECB was not superior to ECC in high-grade lesion detection (p>0.05). Conclusion:Low-grade lesions were diagnosed with ECB, while high-grade lesions were detected with ECC. ECB is a simple and less painful technique and can be used during unsatisfactory colposcopy in low-grade lesions, but more studies are needed.

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“…Colposcopy evaluation as an advanced stage may be necessary in the evaluation of abnormal PAP-smear and HPV-DNA tests used in cervical cancer screening. Biopsy accompanied by colposcopy is accepted as the gold standard in the evaluation of cervical lesions (10). Colposcopy is applied to groups seen to be at risk after the screening HPV and smear tests.…”

Section: Introductionmentioning

confidence: 99%

The Evaluation of Colposcopic Examinations and Cervical Histopathology Results of Women With Abnormal PAP-smear and/or HPV Positivity: A Sample From Amasya

Şahin¹,

Güner²,

Kara³

2020

MJWBS

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Aim:To analyze the colposcopic examinations and cervical histopathology results of women who presented at our clinic with abnormal PAP-smear and/or human papilloma virus (HPV) positivity. Material and Methods:A retrospective examination was made of the colposcopy findings, number of punch biopsies, and final histo-pathological results of patients who presented at the gynecology polyclinic between January 2018 and January 2020 with a smear result showing atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesions (LGSIL), high-grade squamous intraepithelial lesions (HGSIL), and atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (ASC-H), and/or HPV test was 16, 18 and other types of positivity. The Chi-square test was applied in the comparisons of the findings.Results: Evaluation was made of 214 patients with a mean age of 46.54±10.76 years. The PAPsmear results were recorded as ASCUS in 71 (33.2%) patients, ASC-H in 2 (0.9%), LGSIL in 23 (10.7%), HGSIL in 8 (3.7%) and normal or showing inflammation in 110 (51.4%). HPV 16 positivity was determined in 58 (27.1%) patients, HPV 18 positivity in 12 (5.6%), other high-risk type (HR-) HPV positivity in 84 (39.3%) and other type HPV positivity in 53 (24.8%). The colposcopy findings were recorded as leukoplakia in 60 (28%) patients, a punctuation appearance in 40 (18.7%), mosaic appearance in 26 (12.1%), and atypical vascularization in 24 (11.2%). We detected that biopsy was taken from all the colposcopies we made. A single punch biopsy was taken from 53 (24.8%) patients, and multiple biopsies were taken from 161 (75.2%). The histo-pathological results were reported as LGSIL in 45 (21%) patients, HGSIL in 15 (7%) and carcinoma in 1 (0.5%). No correlation was determined between the colposcopic examination findings and the number of punch biopsies (p=0.655). As the number of punch biopsies increased, so the probability of LGSIL, HGSIL and carcinoma increased (p=0.006). Conclusion:Leukoplakia was the most common colposcopic finding. Gynecologists were in favor of taking multiple biopsies in the clinic. LGSIL was the most encountered histo-pathological result. Colposcopy examination findings did not affect the number of punch biopsies, but it was observed that the possibility of detecting cervical premalignant and malignant lesions increased as the number of punch biopsies increased.

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The Colposcopic Examination

Cited by 8 publications

References 39 publications

Age, margin status, high‑risk human papillomavirus and cytology independently predict recurrent high‑grade cervical intraepithelial neoplasia up to 6 years after treatment

Age, margin status, high‑risk human papillomavirus and cytology independently predict recurrent high‑grade cervical intraepithelial neoplasia up to 6 years after treatment

Comparison of endocervical curettage and endocervical brush during unsatisfactory colposcopy for endocervical sampling in human papillomaviruses positive women

The Evaluation of Colposcopic Examinations and Cervical Histopathology Results of Women With Abnormal PAP-smear and/or HPV Positivity: A Sample From Amasya

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