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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Gurumurthy, Mahalakshmi Cotton, Seonaidh C. Sharp, Linda Smart, Louise Little, Julian Waugh, Norman Cruickshank, Margaret E. |
| Description | Country affiliation: United kingdom Author Affiliation: Gurumurthy M ( 1Gynaecological Oncology, University Hospital of Llandough, Wales) |
| Abstract | OBJECTIVES: This study aimed to determine during 36 months of follow-up the (1) clinical outcomes and (2) influence of high-risk human papillomavirus (HPV) status on the risk of progression to cervical intraepithelial neoplasia 2+ (CIN 2+), among women with histologically proven CIN 1. MATERIALS AND METHODS: This is an ad hoc analysis of women with CIN 1 within TOMBOLA, a randomized trial of the management of women with low-grade cervical cytology. Women from the colposcopy arm with CIN 1 confirmed on punch biopsies and managed conservatively by cytology every 6 months in primary care were included. Sociodemographic data and a sample for HPV testing were collected at recruitment. Data on the sample women were extracted to calculate the cumulative incidence of CIN 2+ and the performance characteristics of the baseline HPV test. Detection of CIN 2 or worse (CIN 2+) during follow-up or at exit colposcopy was analyzed. RESULTS: A total of 171 women were included. Their median age was 29 years. Fifty-two percent were high-risk HPV positive, 17% were HPV-16 positive, and 11% were HPV-18 positive. Overall, 21 women (12%) developed CIN 2+, with a median time to detection of 25 months. Factors associated with progression to CIN 2+ were presence of HPV-18 (relative risk = 3.04; 95% CI = 1.09-8.44) and HPV-16 and/or HPV-18 at recruitment (relative risk = 3.98; 95% CI = 1.60-9.90). The sensitivity and specificity of a combined HPV-16/HPV-18 test for the detection of CIN 2+ during 3 years were 58% and 78%, respectively. CONCLUSIONS: Our results suggest that women with confirmed CIN 1 have low rates of progression to high-grade CIN within 3 years. Because the median time to progression was 25 months, conservative management could recommend the next repeat cytology at 2 years. |
| File Format | HTM / HTML |
| ISSN | 10892591 |
| Issue Number | 3 |
| Volume Number | 18 |
| e-ISSN | 15260976 |
| Journal | Journal of Lower Genital Tract Disease |
| Language | English |
| Publisher | Lippincott Williams & Wilkins |
| Publisher Date | 2014-07-01 |
| Publisher Place | United States |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Gynecology Cervical Intraepithelial Neoplasia Diagnosis Therapy Colposcopy Methods Adult Biopsy Disease Progression Female Follow-up Studies Humans Middle Aged Papillomaviridae Isolation & Purification Papillomavirus Infections Virology Prospective Studies Treatment Outcome Young Adult Journal Article Randomized Controlled Trial Research Support, Non-u.s. Gov't |
| Content Type | Text |
| Resource Type | Article |
| Subject | Obstetrics and Gynecology |
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