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Open AccessArticle

Role of Colposcopy after Treatment for Cervical Intraepithelial Neoplasia

Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, 00029 Helsinki, Finland
Department of Obstetrics and Gynecology, Hyvinkää Hospital, HUCH and University of Helsinki, 05850 Hyvinkää, Finland
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
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;
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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