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Open AccessArticle

Role of Colposcopy after Treatment for Cervical Intraepithelial Neoplasia

1
Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, 00029 Helsinki, Finland
2
Department of Obstetrics and Gynecology, Hyvinkää Hospital, HUCH and University of Helsinki, 05850 Hyvinkää, Finland
3
Department of Gut, Metabolism and Reproduction & Department of Surgery and Cancer, Institute of Reproductive and Developmental Biology, Faculty of Medicine, Imperial College London, London SW7 2AZ, UK
4
West London Gynaecological Cancer Centre, Imperial College Healthcare NHS Trust, London W2 1NY, UK
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(6), 1683; https://doi.org/10.3390/cancers12061683
Received: 16 May 2020 / Revised: 13 June 2020 / Accepted: 18 June 2020 / Published: 24 June 2020
(This article belongs to the Special Issue Prevention & Screening in Cervical Cancer)
Colposcopy is often used in follow-up after treatment for cervical intraepithelial neoplasia (CIN) despite its marked inter-observer variability and low sensitivity. Our objective was to assess the role of colposcopy in post-treatment follow-up in comparison to hrHPV (high-risk human papillomavirus) testing, cytology, and cone margin status. Altogether, 419 women treated for histological high-grade lesion (HSIL) with large loop excision of the transformation zone (LLETZ) attended colposcopy with cytology and hrHPV test at six months. Follow-up for recurrence of HSIL continued for 24 months. Colposcopy was considered positive if colposcopic impression was recorded as high grade and cytology if HSIL, ASC-H (atypical squamous cells, cannot exclude HSIL), or AGC-FN (atypical glandular cells, favor neoplasia) were present. Overall, 10 (10/419, 2.4%) recurrent HSIL cases were detected, 5 at 6 months and 5 at 12 months. Colposcopic impression was recorded at 407/419 6-month visits and was positive for 11/407 (2.7%). None of them had recurrent lesions, resulting in 0% sensitivity and 97% specificity for colposcopy. Sensitivity for the hrHPV test at 6 months was 100% and specificity 85%, for cytology 40% and 99%, and for margin status at treatment 60% and 82%, respectively. While the hrHPV test is highly sensitive in predicting recurrence after local treatment for CIN, colposcopy in an unselected population is not useful in follow-up after treatment of CIN. View Full-Text
Keywords: colposcopy; CIN; follow-up; test of cure colposcopy; CIN; follow-up; test of cure
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Heinonen, A.; Jakobsson, M.; Kiviharju, M.; Virtanen, S.; Aro, K.; Kyrgiou, M.; Nieminen, P.; Kalliala, I. Role of Colposcopy after Treatment for Cervical Intraepithelial Neoplasia. Cancers 2020, 12, 1683.

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