Overtreatment in the see-and-treat approach for high-grade squamous cervical cytology
Objectives: To evaluate overtreatment with the ‘see-and-treat’ approach in patients with high-grade squamous cervical cytology, and identify the clinical factors associated with overtreatment. Study design: Patients with high-grade squamous intra-epithelial lesion (HSIL) cytology undergoing colposco...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-09-01
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| Series: | European Journal of Obstetrics & Gynecology and Reproductive Biology: X |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590161323000303 |
| _version_ | 1797683023954575360 |
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| author | W. Rongthongaram S. Plumworasawat C. Charakorn A.A. Lertkhachonsuk S. Satitniramai |
| author_facet | W. Rongthongaram S. Plumworasawat C. Charakorn A.A. Lertkhachonsuk S. Satitniramai |
| author_sort | W. Rongthongaram |
| collection | DOAJ |
| description | Objectives: To evaluate overtreatment with the ‘see-and-treat’ approach in patients with high-grade squamous cervical cytology, and identify the clinical factors associated with overtreatment. Study design: Patients with high-grade squamous intra-epithelial lesion (HSIL) cytology undergoing colposcopy and loop electrosurgical excision procedure (LEEP) in a single visit or the ‘see-and-treat’ approach from January 2005 to December 2019 were reviewed retrospectively. The overtreatment rate and complications following LEEP were explored. Results: In total, 220 cases were identified. The overtreatment rate was 11.4%, and surgical complications were haemorrhage (n = 3, 1.36%) and infection (n = 9, 4.09%). On univariable analysis, factors associated with overtreatment were current cytological result and colposcopic impression. On multi-variable analysis, current cytological result of non-HSIL compared with HSIL/cancer, and colposcopic diagnosis of low-grade lesion or normal compared with high-grade lesion or cancer had adjusted odds ratios of 13.81 [95% confidence interval (CI) 1.23–155.20; p = 0.033] and 3.58 (95% CI 1.32–9.74; p = 0.013), respectively. Conclusions: The overtreatment rate with the ‘see-and-treat’ approach was 11.4%. Independent factors associated with overtreatment were current cervical cytological result of non-HSIL, and low-grade or normal colposcopic diagnosis. |
| first_indexed | 2024-03-12T00:08:28Z |
| format | Article |
| id | doaj.art-adf19c7c0aff4290b9da28d8089eecb1 |
| institution | Directory Open Access Journal |
| issn | 2590-1613 |
| language | English |
| last_indexed | 2024-03-12T00:08:28Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Journal of Obstetrics & Gynecology and Reproductive Biology: X |
| spelling | doaj.art-adf19c7c0aff4290b9da28d8089eecb12023-09-16T05:31:39ZengElsevierEuropean Journal of Obstetrics & Gynecology and Reproductive Biology: X2590-16132023-09-0119100205Overtreatment in the see-and-treat approach for high-grade squamous cervical cytologyW. Rongthongaram0S. Plumworasawat1C. Charakorn2A.A. Lertkhachonsuk3S. Satitniramai4Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDepartment of Pathology, Division of Anatomical Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDepartment of Obstetrics and Gynaecology, Division of Gynaecologic Oncology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDepartment of Obstetrics and Gynaecology, Division of Gynaecologic Oncology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDepartment of Obstetrics and Gynaecology, Division of Gynaecologic Oncology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; Correspondence to: Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Rd, Thung Phayathai, Ratchathewi District, Bangkok 10400, Thailand.Objectives: To evaluate overtreatment with the ‘see-and-treat’ approach in patients with high-grade squamous cervical cytology, and identify the clinical factors associated with overtreatment. Study design: Patients with high-grade squamous intra-epithelial lesion (HSIL) cytology undergoing colposcopy and loop electrosurgical excision procedure (LEEP) in a single visit or the ‘see-and-treat’ approach from January 2005 to December 2019 were reviewed retrospectively. The overtreatment rate and complications following LEEP were explored. Results: In total, 220 cases were identified. The overtreatment rate was 11.4%, and surgical complications were haemorrhage (n = 3, 1.36%) and infection (n = 9, 4.09%). On univariable analysis, factors associated with overtreatment were current cytological result and colposcopic impression. On multi-variable analysis, current cytological result of non-HSIL compared with HSIL/cancer, and colposcopic diagnosis of low-grade lesion or normal compared with high-grade lesion or cancer had adjusted odds ratios of 13.81 [95% confidence interval (CI) 1.23–155.20; p = 0.033] and 3.58 (95% CI 1.32–9.74; p = 0.013), respectively. Conclusions: The overtreatment rate with the ‘see-and-treat’ approach was 11.4%. Independent factors associated with overtreatment were current cervical cytological result of non-HSIL, and low-grade or normal colposcopic diagnosis.http://www.sciencedirect.com/science/article/pii/S2590161323000303ColposcopyHigh-grade squamous cytologyOvertreatmentSee-and-treat |
| spellingShingle | W. Rongthongaram S. Plumworasawat C. Charakorn A.A. Lertkhachonsuk S. Satitniramai Overtreatment in the see-and-treat approach for high-grade squamous cervical cytology European Journal of Obstetrics & Gynecology and Reproductive Biology: X Colposcopy High-grade squamous cytology Overtreatment See-and-treat |
| title | Overtreatment in the see-and-treat approach for high-grade squamous cervical cytology |
| title_full | Overtreatment in the see-and-treat approach for high-grade squamous cervical cytology |
| title_fullStr | Overtreatment in the see-and-treat approach for high-grade squamous cervical cytology |
| title_full_unstemmed | Overtreatment in the see-and-treat approach for high-grade squamous cervical cytology |
| title_short | Overtreatment in the see-and-treat approach for high-grade squamous cervical cytology |
| title_sort | overtreatment in the see and treat approach for high grade squamous cervical cytology |
| topic | Colposcopy High-grade squamous cytology Overtreatment See-and-treat |
| url | http://www.sciencedirect.com/science/article/pii/S2590161323000303 |
| work_keys_str_mv | AT wrongthongaram overtreatmentintheseeandtreatapproachforhighgradesquamouscervicalcytology AT splumworasawat overtreatmentintheseeandtreatapproachforhighgradesquamouscervicalcytology AT ccharakorn overtreatmentintheseeandtreatapproachforhighgradesquamouscervicalcytology AT aalertkhachonsuk overtreatmentintheseeandtreatapproachforhighgradesquamouscervicalcytology AT ssatitniramai overtreatmentintheseeandtreatapproachforhighgradesquamouscervicalcytology |