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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...

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Detalles Bibliográficos
Autores principales: Rongthongaram, W., Plumworasawat, S., Charakorn, C., Lertkhachonsuk, A.A., Satitniramai, S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10518508/
https://www.ncbi.nlm.nih.gov/pubmed/37753518
http://dx.doi.org/10.1016/j.eurox.2023.100205
Descripción
Sumario: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.