Can biopsies be omitted after normal colposcopy in women referred with low-grade cervical cytology? A prospective cohort study

Abstract Background Controversy surrounds whether women with low-risk cytology screening results but a normal colposcopic assessment should have random biopsies taken. The aim of this study was to determine the yield of CIN2+ from one to four cervical biopsies in women with cytology of LSIL or ASCUS...

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Autores principales:	Mette Mindedahl Jespersen, Berit Bargum Booth, Lone Kjeld Petersen
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Atypical squamous cells of the cervix Squamous intraepithelial lesions Cervical intraepithelial neoplasia Biopsy Colposcopy Diagnosis Gynecology and obstetrics RG1-991 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/f5a7db4bf19444b6908b444f099644d7
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spelling	oai:doaj.org-article:f5a7db4bf19444b6908b444f099644d72021-11-21T12:08:44ZCan biopsies be omitted after normal colposcopy in women referred with low-grade cervical cytology? A prospective cohort study10.1186/s12905-021-01537-51472-6874https://doaj.org/article/f5a7db4bf19444b6908b444f099644d72021-11-01T00:00:00Zhttps://doi.org/10.1186/s12905-021-01537-5https://doaj.org/toc/1472-6874Abstract Background Controversy surrounds whether women with low-risk cytology screening results but a normal colposcopic assessment should have random biopsies taken. The aim of this study was to determine the yield of CIN2+ from one to four cervical biopsies in women with cytology of LSIL or ASCUS and a normal colposcopic impression. Methods Between January 2017 and September 2020, women over 18 years old referred for colposcopic examination due to either an abnormal smear (ASCUS+) or follow-up after previous cervical intraepithelial neoplasia (CIN) were invited to participate in the study. All study participants underwent colposcopic examination and had four biopsies taken. The biopsies were analyzed separately. Results In total, 1327 women with abnormal cervical cancer screening results or attending follow-up after a previous CIN diagnosis were enrolled in the study and examined by colposcopy. Of these, 173 were newly referred with cytology of LSIL or ASCUS and had a normal colposcopic impression and four adequate biopsies. Of these, 22.0% were diagnosed with CIN2+. When combining the results of the four biopsies, we found a 100% relative increase in CIN2+ cases compared to using only one biopsy (from 11.0% to 22.0%, P = 0.006). Conclusion As we found CIN2+ from random cervical biopsies in 22.0% of women with cytology of LSIL or ASCUS who had a normal colposcopic impression, we advocate performing four random cervical biopsies at the squamocolumnar junction in such women. Trial registration NCT04249856, January 31 2020 (retrospectively registered).Mette Mindedahl JespersenBerit Bargum BoothLone Kjeld PetersenBMCarticleAtypical squamous cells of the cervixSquamous intraepithelial lesionsCervical intraepithelial neoplasiaBiopsyColposcopyDiagnosisGynecology and obstetricsRG1-991Public aspects of medicineRA1-1270ENBMC Women's Health, Vol 21, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Atypical squamous cells of the cervix Squamous intraepithelial lesions Cervical intraepithelial neoplasia Biopsy Colposcopy Diagnosis Gynecology and obstetrics RG1-991 Public aspects of medicine RA1-1270
spellingShingle	Atypical squamous cells of the cervix Squamous intraepithelial lesions Cervical intraepithelial neoplasia Biopsy Colposcopy Diagnosis Gynecology and obstetrics RG1-991 Public aspects of medicine RA1-1270 Mette Mindedahl Jespersen Berit Bargum Booth Lone Kjeld Petersen Can biopsies be omitted after normal colposcopy in women referred with low-grade cervical cytology? A prospective cohort study
description	Abstract Background Controversy surrounds whether women with low-risk cytology screening results but a normal colposcopic assessment should have random biopsies taken. The aim of this study was to determine the yield of CIN2+ from one to four cervical biopsies in women with cytology of LSIL or ASCUS and a normal colposcopic impression. Methods Between January 2017 and September 2020, women over 18 years old referred for colposcopic examination due to either an abnormal smear (ASCUS+) or follow-up after previous cervical intraepithelial neoplasia (CIN) were invited to participate in the study. All study participants underwent colposcopic examination and had four biopsies taken. The biopsies were analyzed separately. Results In total, 1327 women with abnormal cervical cancer screening results or attending follow-up after a previous CIN diagnosis were enrolled in the study and examined by colposcopy. Of these, 173 were newly referred with cytology of LSIL or ASCUS and had a normal colposcopic impression and four adequate biopsies. Of these, 22.0% were diagnosed with CIN2+. When combining the results of the four biopsies, we found a 100% relative increase in CIN2+ cases compared to using only one biopsy (from 11.0% to 22.0%, P = 0.006). Conclusion As we found CIN2+ from random cervical biopsies in 22.0% of women with cytology of LSIL or ASCUS who had a normal colposcopic impression, we advocate performing four random cervical biopsies at the squamocolumnar junction in such women. Trial registration NCT04249856, January 31 2020 (retrospectively registered).
format	article
author	Mette Mindedahl Jespersen Berit Bargum Booth Lone Kjeld Petersen
author_facet	Mette Mindedahl Jespersen Berit Bargum Booth Lone Kjeld Petersen
author_sort	Mette Mindedahl Jespersen
title	Can biopsies be omitted after normal colposcopy in women referred with low-grade cervical cytology? A prospective cohort study
title_short	Can biopsies be omitted after normal colposcopy in women referred with low-grade cervical cytology? A prospective cohort study
title_full	Can biopsies be omitted after normal colposcopy in women referred with low-grade cervical cytology? A prospective cohort study
title_fullStr	Can biopsies be omitted after normal colposcopy in women referred with low-grade cervical cytology? A prospective cohort study
title_full_unstemmed	Can biopsies be omitted after normal colposcopy in women referred with low-grade cervical cytology? A prospective cohort study
title_sort	can biopsies be omitted after normal colposcopy in women referred with low-grade cervical cytology? a prospective cohort study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/f5a7db4bf19444b6908b444f099644d7
work_keys_str_mv	AT mettemindedahljespersen canbiopsiesbeomittedafternormalcolposcopyinwomenreferredwithlowgradecervicalcytologyaprospectivecohortstudy AT beritbargumbooth canbiopsiesbeomittedafternormalcolposcopyinwomenreferredwithlowgradecervicalcytologyaprospectivecohortstudy AT lonekjeldpetersen canbiopsiesbeomittedafternormalcolposcopyinwomenreferredwithlowgradecervicalcytologyaprospectivecohortstudy
_version_	1718419220026359808

Can biopsies be omitted after normal colposcopy in women referred with low-grade cervical cytology? A prospective cohort study

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