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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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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
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author Rongthongaram, W.
Plumworasawat, S.
Charakorn, C.
Lertkhachonsuk, A.A.
Satitniramai, S.
author_facet Rongthongaram, W.
Plumworasawat, S.
Charakorn, C.
Lertkhachonsuk, A.A.
Satitniramai, S.
author_sort Rongthongaram, W.
collection PubMed
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.
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spelling pubmed-105185082023-09-26 Overtreatment in the see-and-treat approach for high-grade squamous cervical cytology Rongthongaram, W. Plumworasawat, S. Charakorn, C. Lertkhachonsuk, A.A. Satitniramai, S. Eur J Obstet Gynecol Reprod Biol X Gynaecology: Oncology 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. Elsevier 2023-06-07 /pmc/articles/PMC10518508/ /pubmed/37753518 http://dx.doi.org/10.1016/j.eurox.2023.100205 Text en © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Gynaecology: Oncology
Rongthongaram, W.
Plumworasawat, S.
Charakorn, C.
Lertkhachonsuk, A.A.
Satitniramai, S.
Overtreatment in the see-and-treat approach for high-grade squamous cervical cytology
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 Gynaecology: Oncology
url 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
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