9,295 results match your criteria Colposcopy


A prevalence and psychometric study on fear of cancer in women with abnormal cervical cytology undergoing colposcopy.

Psychooncology 2020 Aug 3. Epub 2020 Aug 3.

Department of Obstetrics and Gynaecology, Akdeniz University Faculty of Nursing, Antalya.

Objective: To determine the levels of fear of cancer in women who were referred for colposcopy and to determine validity and reliability of the Cancer Worry Scale (CWS) in gynaecology patients.

Methods: The study was conducted between March-November 2017 with 200 women at the Gynaecologic Oncology Clinic at Akdeniz University Hospital in Turkey. Reliability analysis, confirmatory factor analyses, and multidimensional sum-score estimation were used for psychometric analyses. Read More

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http://dx.doi.org/10.1002/pon.5504DOI Listing

[The value of p16(INK4a) cytology for early diagnosis of cervical cancer].

Zhonghua Bing Li Xue Za Zhi 2020 Aug;49(8):812-815

Department of Gynecology and Obstetrics, Peking University Shenzhen Hospital, Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological Diseases, Shenzhen 518036, China.

To investigate the use of p16(INK4a) immuno-stained cytology as the primary screening for cervical cancer prevention. From March to August 2018, 902 women from Shenzhen and surrounding area were recruited for cervical cancer screening with ThinPrep Cytologic Test (TCT), cobas4800 HPV test, and p16(INK4a) co-test. Colpo/biopsies were performed using the point of interest biopsy protocol of directed and random cervical biopsies plus endocervical curettage for all women, any of whose tests was positive. Read More

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http://dx.doi.org/10.3760/cma.j.cn112151-20191203-00779DOI Listing

[Comparison of the clinicopathological features between adenoid basal cell carcinoma and adenoid cystic carcinoma of the cervix].

Zhonghua Bing Li Xue Za Zhi 2020 Aug;49(8):800-805

Department of Pathology, the First Medical Center of PLA General Hospital, Beijing 100853, China.

To compare the clinical and histopathological characteristics of cervical adenoid basal cell carcinoma and adenoid cystic carcinoma for improving the diagnosis accuracy and differential diagnosis of these tumors. A retrospective study was conducted on 9 cases of cervical adenoid basal cell carcinoma and 3 cases of adenoid cystic carcinoma which were diagnosed and consulted at the First Medical Center of PLA General Hospital from March 2009 to April 2019. Detailed clinical data were reviewed. Read More

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http://dx.doi.org/10.3760/cma.j.cn112151-20191117-00735DOI Listing

p16/ki67 and E6/E7 mRNA accuracy and prognostic value in triaging HPV DNA-positive women.

J Natl Cancer Inst 2020 Aug 3. Epub 2020 Aug 3.

IRCCS - Regina Elena National Cancer Institute, Via Elio Chianesi, 53, Rome, Italy.

Background: The study presents cross-sectional accuracy of E6/E7 mRNA detection and p16/ki67 dual staining, alone or in combination with cytology and HPV16/18 genotyping, as triage test in HPV DNA-positive women and their impact on CIN2+ overdiagnosis.

Methods: Women aged 25-64 were recruited. HPV DNA-positives were triaged with cytology and tested for E6/E7 mRNA and p16/ki67. Read More

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http://dx.doi.org/10.1093/jnci/djaa105DOI Listing

Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society.

CA Cancer J Clin 2020 Jul 30. Epub 2020 Jul 30.

Prevention and Early Detection Department, American Cancer Society, Atlanta, Georgia.

The American Cancer Society (ACS) recommends that individuals with a cervix initiate cervical cancer screening at age 25 years and undergo primary human papillomavirus (HPV) testing every 5 years through age 65 years (preferred); if primary HPV testing is not available, then individuals aged 25 to 65 years should be screened with cotesting (HPV testing in combination with cytology) every 5 years or cytology alone every 3 years (acceptable) (strong recommendation). The ACS recommends that individuals aged >65 years who have no history of cervical intraepithelial neoplasia grade 2 or more severe disease within the past 25 years, and who have documented adequate negative prior screening in the prior 10 years, discontinue all cervical cancer screening (qualified recommendation). These new screening recommendations differ in 4 important respects compared with the 2012 recommendations: 1) The preferred screening strategy is primary HPV testing every 5 years, with cotesting and cytology alone acceptable where access to US Food and Drug Administration-approved primary HPV testing is not yet available; 2) the recommended age to start screening is 25 years rather than 21 years; 3) primary HPV testing, as well as cotesting or cytology alone when primary testing is not available, is recommended starting at age 25 years rather than age 30 years; and 4) the guideline is transitional, ie, options for screening with cotesting or cytology alone are provided but should be phased out once full access to primary HPV testing for cervical cancer screening is available without barriers. Read More

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http://dx.doi.org/10.3322/caac.21628DOI Listing

Influence of Demographic and Reproductive Factors on Cervical Pre-Cancer and Cancer in Bangladesh.

Asian Pac J Cancer Prev 2020 Jul 1;21(7):1883-1889. Epub 2020 Jul 1.

Institute of Epidemiology, Diseese Control and Research (IEDCR), Directorate General of Health Services, Mohakhali, Dhaka-1212, Bangladesh.

Background: In Bangladesh, cervical cancer (CC) is the 2nd most common cancer with estimated 8068 new cases and 5,214 deaths every year. It is also revealed that different socio-demographic factors have association with CC. This study was performed to evaluate the colposcopy outcomes and the association of different demographic and reproductive risk factors with cervical pre-cancer and cancer. Read More

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http://dx.doi.org/10.31557/APJCP.2020.21.7.1883DOI Listing

A sustainable model for raising colposcopy expertise in low-to-middle-income countries.

Int J Gynecol Cancer 2020 Jul 23. Epub 2020 Jul 23.

Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, National University of Singapore, Singapore

Objective: The objective of the study was to assess the effectiveness of training low-to-middle-income countries' local healthcare providers using the Train-the-trainers model in basic colposcopy for cervical cancer prevention.

Method: This project was designed based on a philosophy known as Train-the-trainers which train proficient colposcopists and a cadre of local trainers who can continue to train and maintain their expertise in a self-sustaining system. The Train-the-trainers workshop is a 1-day program that focuses on three domains; knowledge, communication, and practical skills. Read More

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http://dx.doi.org/10.1136/ijgc-2020-001306DOI Listing

Selecting human papillomavirus genotypes to optimize the performance of screening tests among South African women.

Cancer Med 2020 Jul 24. Epub 2020 Jul 24.

Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, USA.

Human papillomavirus (HPV) testing is highly sensitive compared to cytology, with the trade-off of being less specific. We investigated whether select combinations of HPV genotypes, ascertained by Linear Array (LA) and Xpert HPV (GX), can optimize sensitivity/specificity trade-offs to detect high-grade cervical intraepithelial neoplasia (CIN2+). In a study in Cape Town, South Africa, 586 women living without and 535 living with HIV, aged 30-65 years, were recruited. Read More

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http://dx.doi.org/10.1002/cam4.3329DOI Listing

The artificial intelligence-assisted cytology diagnostic system in large-scale cervical cancer screening: A population-based cohort study of 0.7 million women.

Cancer Med 2020 Jul 22. Epub 2020 Jul 22.

Landing Cloud Medical Laboratory Co., Wuhan, China.

Background: Adequate cytology is limited by insufficient cytologists in a large-scale cervical cancer screening. We aimed to develop an artificial intelligence (AI)-assisted cytology system in cervical cancer screening program.

Methods: We conducted a perspective cohort study within a population-based cervical cancer screening program for 0. Read More

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http://dx.doi.org/10.1002/cam4.3296DOI Listing

Atypical squamous cells of undetermined significance cervical cytology in the Chinese population: Age-stratified reporting rates, high-risk HPV testing, and immediate histologic correlation results.

Cancer Cytopathol 2020 Jul 22. Epub 2020 Jul 22.

Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.

Background: The US American Society of Colposcopy and Cervical Pathology guidelines for cervical cancer screening have been largely adopted worldwide. Pooled high-risk human papillomavirus (hrHPV) testing has been routinely used to risk-stratify women who have atypical squamous cells of undetermined significance (ASC-US) cytology. However, it has been reported that there are distinguished differences in the distribution of hrHPV genotypes between the Chinese and American populations. Read More

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http://dx.doi.org/10.1002/cncy.22333DOI Listing

Overexpression of programmed cell death ligand 1 in patients with CIN and its correlation with human papillomavirus infection and CIN persistence.

Infect Agent Cancer 2020 17;15:47. Epub 2020 Jul 17.

Department of Obstetrics and Gynecology, School of Medicine, Balikesir University, Cagis Yerleskesi, Bigadic yolu 17. km pc:10345, Balikesir, Türkiye.

Backround: HPV causes specific cell-mediated immunity in the cervix. Mononuclear cells such as helper T cells (CD4+), cytotoxic T cells (CD8+), and dendritic cells play a critical role in the initiation of the HPV-specific immune response and destruction of virus-infected cervical epithelial cells. The programmed cell death ligand 1 (PD-L1) gene encodes an immune inhibitory receptor ligand and overexpression of PD-L1 inhibits T-cell activation and cytokine production. Read More

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http://dx.doi.org/10.1186/s13027-020-00312-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7367318PMC

Value of multi-quadrants biopsy: Pooled analysis of 11 population-based cervical cancer screening studies.

Chin J Cancer Res 2020 Jun;32(3):383-394

Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

Objective: The accuracy of colposcopy-guided biopsy is key to the success of colposcopic triage in cervical cancer screening programs. However, there is no widely adopted biopsy guideline up to date. Our study aimed to determine whether multi-quadrants biopsy improves the yield of cervical lesions. Read More

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http://dx.doi.org/10.21147/j.issn.1000-9604.2020.03.09DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7369178PMC

Streptococcus agalactiae-Induced Soft Tissue Infection in a Nonpregnant Adult After a Gynecological Procedure.

Am J Case Rep 2020 Jul 18;21:e924110. Epub 2020 Jul 18.

Department of Medicine, Anne Arundel Medical Center, Annapolis, MD, USA.

BACKGROUND We present a case of a 24-year-old woman with type 1- diabetes mellitus who developed necrotizing fasciitis (NF) due to Streptococcus agalactiae after a recent colposcopy. Literature review suggests this as the first case to be reported. CASE REPORT The patient initially presented to the emergency department (ED) with right lower neck pain and spasm of the right sternocleidomastoid muscle (SCM), with decreased range of motion. Read More

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http://dx.doi.org/10.12659/AJCR.924110DOI Listing

Role of molecular biomarker human papilloma virus (HPV) E6 oncoprotein in cervical cancer screening.

Gynecol Oncol 2020 Jul 14. Epub 2020 Jul 14.

Massachusetts General Hospital, USA. Electronic address:

Objective: The Onco E6™ Cervical Test, based on detection of the E6 oncoprotein of HPV 16 and 18 genotypes is evaluated as a screen for the early detection cervical neoplasia in resource-limited countries.

Methods: This prospective study from June 2018 to June 2019 evaluated 235 women aged 21-65 years, who came to Gynaecological Oncology Outpatient Department by VIA, cytology, E6 oncoprotein test and by colposcopy. Screen-positive women by any of the tests or women with suspicious findings were further evaluated by biopsy at colposcopy. Read More

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http://dx.doi.org/10.1016/j.ygyno.2020.06.496DOI Listing

A comparison of screening tests for detection of high-grade cervical abnormalities in women living with HIV from Cameroon.

Infect Agent Cancer 2020 11;15:45. Epub 2020 Jul 11.

Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY USA.

Background: Women living with human immunodeficiency virus (WLWH), especially those living in low- and middle-income countries (LMIC), are at increased risk of cervical cancer. The optimal cervical-cancer screening strategy for WLWH has not been determined. We therefore conducted a pilot study of screening methods in WLWH living in Limbe, Cameroon. Read More

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http://dx.doi.org/10.1186/s13027-020-00311-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7353796PMC

The Efficiency of Type-Specific High-Risk Human Papillomavirus Models in the Triage of Women with Atypical Squamous Cells of Undetermined Significance.

Cancer Manag Res 2020 1;12:5265-5275. Epub 2020 Jul 1.

Department of Central Laboratory, Longyan First Hospital Affiliated to Fujian Medical University, Longyan, People's Republic of China.

Purpose: To evaluate the performance of different high-risk human papillomavirus (HR-HPV) genotype models in triaging women with cytological diagnosis of atypical squamous cells of undetermined significance (ASCUS).

Patients And Methods: A total of 36,679 Chinese women who underwent cytology and HR-HPV genotyping assessments during cervical cancer screening were enrolled in this study. Women with cytology-proven ASCUS were referred for further screening by colposcopy and biopsy. Read More

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http://dx.doi.org/10.2147/CMAR.S254330DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7335862PMC

The application of deep learning based diagnostic system to cervical squamous intraepithelial lesions recognition in colposcopy images.

Sci Rep 2020 Jul 15;10(1):11639. Epub 2020 Jul 15.

Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China.

Background Deep learning has presented considerable potential and is gaining more importance in computer assisted diagnosis. As the gold standard for pathologically diagnosing cervical intraepithelial lesions and invasive cervical cancer, colposcopy-guided biopsy faces challenges in improving accuracy and efficiency worldwide, especially in developing countries. To ease the heavy burden of cervical cancer screening, it is urgent to establish a scientific, accurate and efficient method for assisting diagnosis and biopsy. Read More

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http://dx.doi.org/10.1038/s41598-020-68252-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7363819PMC
July 2020
5.078 Impact Factor

Analysis of count data in the setting of cervical cancer detection.

J Investig Med 2020 Aug 13;68(6):1196-1198. Epub 2020 Jul 13.

Department of Obstetrics and Gynecology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA

Women with an abnormal Pap smear are often referred to colposcopy, a procedure during which endocervical curettage (ECC) may be performed. ECC is a scraping of the endocervical canal lining. Our goal was to compare the performance of a naïve Poisson (NP) regression model with that of a zero-inflated Poisson (ZIP) model when identifying predictors of the number of distress/pain vocalizations made by women undergoing ECC. Read More

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http://dx.doi.org/10.1136/jim-2020-001381DOI Listing

Human Papillomavirus-Associated Anogenital Pathology in Females With HPV-Positive Oropharyngeal Squamous Cell Carcinoma.

Otolaryngol Head Neck Surg 2020 Jul 14:194599820941499. Epub 2020 Jul 14.

Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.

We sought to determine the incidence and location of human papillomavirus (HPV)-associated anogenital disease in women with HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) via a retrospective cohort study with prospective contact to update history at Mayo Clinic in Rochester, Minnesota. Females undergoing treatment for nonmetastatic HPV-positive OPSCC from 2011 to 2019 were identified. Clinical history and outcomes were abstracted from medical records. Read More

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http://dx.doi.org/10.1177/0194599820941499DOI Listing

Long-term immunogenicity, effectiveness, and safety of nine-valent human papillomavirus vaccine in girls and boys 9 to 15 years of age: Interim analysis after 8 years of follow-up.

Papillomavirus Res 2020 Jul 11;10:100203. Epub 2020 Jul 11.

Merck & Co., Inc., Kenilworth, NJ, USA. Electronic address:

Background: The nine-valent human papillomavirus (9vHPV) vaccine protects against infection and disease related to HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58. The pivotal 36-month Phase III immunogenicity study of 9vHPV vaccine in 9- to 15-year-old girls and boys was extended to assess long-term immunogenicity and effectiveness through approximately 10 years after vaccination. We describe results of an interim analysis based on approximately 8 years of follow-up after vaccination. Read More

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http://dx.doi.org/10.1016/j.pvr.2020.100203DOI Listing

Assessing Physician Adherence to Guidelines for CervicalCancer Screening and Management of Abnormal Screening Results.

J Low Genit Tract Dis 2020 Jul 8. Epub 2020 Jul 8.

Division of Gynecologic Oncology, Washington University School of Medicine, Alvin J. Siteman Cancer Center, St. Louis, MO.

Objective: The aim of the study was to survey obstetrician-gynecologists' cervical cancer screening practices and management of cervical abnormalities to ascertain adherence to guidelines.

Methods: From January to July 2019, obstetrician-gynecologists at 5 St. Louis area hospitals were surveyed online about cervical cancer screening and management practices through 13 clinical vignettes. Read More

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http://dx.doi.org/10.1097/LGT.0000000000000558DOI Listing

Cost-effectiveness of HPV-based cervical screening based on first year results in the Netherlands: a modelling study.

BJOG 2020 Jul 7. Epub 2020 Jul 7.

Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.

Objective: We aim to compare the cost-effectiveness of the old cytology programme with the new high-risk human papillomavirus (hrHPV) screening programme, using performance indicators from the new Dutch hrHPV screening programme.

Design: Model-based cost-effectiveness analysis.

Setting: The Netherlands. Read More

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http://dx.doi.org/10.1111/1471-0528.16400DOI Listing

Comparison of the detection rate of cervical lesion with TruScreen, LBC test and HPV test: A Real-world study based on population screening of cervical cancer in rural areas of China.

PLoS One 2020 7;15(7):e0233986. Epub 2020 Jul 7.

National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China.

Background And Objective: China carries a heavy burden of cervical cancer and has an alarmingly low cervical cancer screening rate. In order to achieve the goal of cervical cancer elimination, there is an urgent need for suitable methods and strategies in China.

Materials And Methods: A total 9972 woman who received cervical cancer screening services of National Cervical Cancer Screening Program in Rural Areas (NCCSPRA) in 8 project counties participated in this study. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0233986PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340311PMC
July 2020
3.234 Impact Factor

HPV Vaccination: The Position Paper of the Italian Society of Colposcopy and Cervico-Vaginal Pathology (SICPCV).

Vaccines (Basel) 2020 Jul 2;8(3). Epub 2020 Jul 2.

Gynecology and Obstetrics, Division of Gynecologic Oncology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.

Human papillomavirus (HPV) related cervical cancer represents an issue of public health priority. The World Health Organization recommended the introduction of HPV vaccination in all national public programs. In Europe, vaccines against HPV have been available since 2006. Read More

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http://dx.doi.org/10.3390/vaccines8030354DOI Listing

COLPOSCOPY 2020 - COLPOSCOPY PROTOCOLS: A Summary of the Clinical Experts Consensus Guidelines of the Polish Society of Colposcopy and Cervical Pathophysiology and the Polish Society of Gynaecologists and Obstetricians.

Ginekol Pol 2020 ;91(6):362371

Department of Gynecology and Oncology, Jagiellonian University Medical College, Cracow, Poland.

The Polish Society of Colposcopy and Cervical Pathophysiology and the Polish Society of Gynecologists and Obstetricians provide comprehensive guidelines for colposcopy practice in secondary cervical cancer prevention in Poland. This part of the guidelines, developed by the clinical experts of the Working Group No. 1 (WG1), concerns the colposcopy protocols with the main aim of algorithmizing the procedure, together with all procedure-related processes. Read More

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http://dx.doi.org/10.5603/GP.2020.0075DOI Listing
January 2020

The relationship between the presence of HPV infection and biofilm formation in cervicovaginal smears.

Infection 2020 Jul 4. Epub 2020 Jul 4.

Department of Gynecology and Obstetrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Purpose: To demonstrate and understand the association of HPV infection and biofilm formation.

Methods: The study consisted of cervicovaginal samples of 72 women who were evaluated at the colposcopy unit. Papanicolaou staining was used for cytological examination while "Crystal Violet Binding" assay was performed to detect biofilm formation. Read More

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http://dx.doi.org/10.1007/s15010-020-01478-5DOI Listing

Health-related quality of life of women after HPV testing as triage strategy for an abnormal Pap smear: a nested randomized pragmatic trial in a middle-income country.

Qual Life Res 2020 Jul 2. Epub 2020 Jul 2.

Grupo de Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia.

Background: Information obtained in studies on the impact of human papilloma virus (HPV) testing on health-related quality of life is contradictory.

Objective: To assess the impact on health-related quality of life of the HPV test, colposcopy, and cytology as triage strategies after a cytology with atypical squamous cells of undetermined significance (ASCUS) in Medellín, Colombia.

Methods: We carried out a nested analysis on the randomized pragmatic trial (ASCUS-COL). Read More

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http://dx.doi.org/10.1007/s11136-020-02563-wDOI Listing
July 2020
2.486 Impact Factor

To Evaluate the Role of p16 Immunocytochemistry for Detection of CIN2+ in Women Detected Screen Positive by Visual Inspection Using Acetic Acid.

J Cytol 2020 Apr-Jun;37(2):82-86. Epub 2020 Apr 14.

Department of Pathology, Vardhmaan Mahaveer Medical College and Safdarjung Hospital, New Delhi, India.

Objective: To evaluate the role of p16 immunostaining for the detection of cervical intraepithelial neoplasia (CIN2+) in women who had a positive screening test using visual inspection with acetic acid (VIA).

Methods: Opportunistic screening of women (30-50 years) coming to the gynecology clinic by VIA was performed; the screen-positive women were included in the study which had the institutional review board (IRB) approval. A cytology slide for p16 immunostaining, colposcopy, and biopsy was then performed sequentially. Read More

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http://dx.doi.org/10.4103/JOC.JOC_89_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315916PMC
April 2020
0.413 Impact Factor

Is There a Place for the Introduction of Colposcopy Quality Standards?

J Low Genit Tract Dis 2020 Jun 29. Epub 2020 Jun 29.

Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, Israel.

Objectives: The aims of the study were to examine the degree of compliance with international quality measures for colposcopy in Israel, which does not currently have formal guidelines and to compare the achievement of quality measures between clinical settings.

Methods: This is a retrospective cohort study, in a hospital, a community clinic, and 2 private colposcopy clinics in Israel, including women aged 18-70 years presenting for colposcopy after abnormal Pap results. Compliance was compared between clinical sites regarding 6 international standards: documentation of reason for referral, type of transformation zone, biopsy location, and grade; proportion of women with high-degree cytological abnormalities (atypical squamous cells - cannot exclude high grade squamous intraepithelial lesion and above) receiving a colposcopy within 4 weeks; and the positive predictive value of colposcopy to detect cervical intraepithelial neoplasia 2 and above. Read More

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http://dx.doi.org/10.1097/LGT.0000000000000557DOI Listing

Cervical Colposcopy: Indications and Risk Assessment.

Am Fam Physician 2020 Jul;102(1):39-48

Oregon Health & Science University, Portland, OR, USA.

The practice of colposcopy, a diagnostic procedure to evaluate for vaginal, vulvar, and cervical dysplasia, has evolved to incorporate patient risk factors for high-grade cervical intraepithelial neoplasia (CIN) and cancer. Changes in cervical cancer screening and guidelines, human papillomavirus (HPV) vaccination recommendations, and colposcopy standards from the American Society for Colposcopy and Cervical Pathology (ASCCP) have implications for all primary care clinicians, not only those who perform colposcopies. Primary care clinicians should offer HPV vaccination to all patients between the ages of nine and 26, in addition to cervical cancer screening and follow-up guidance. Read More

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Role of Colposcopy after Treatment for Cervical Intraepithelial Neoplasia.

Cancers (Basel) 2020 Jun 24;12(6). Epub 2020 Jun 24.

Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, 00029 Helsinki, Finland.

Colposcopy is often used in follow-up after treatment for cervical intraepithelial neoplasia (CIN) despite its marked inter-observer variability and low sensitivity. Our objective was to assess the role of colposcopy in post-treatment follow-up in comparison to hrHPV (high-risk human papillomavirus) testing, cytology, and cone margin status. Altogether, 419 women treated for histological high-grade lesion (HSIL) with large loop excision of the transformation zone (LLETZ) attended colposcopy with cytology and hrHPV test at six months. Read More

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http://dx.doi.org/10.3390/cancers12061683DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7352967PMC

Value of endocervical curettage in follow-up for patients with cervical intraepithelial neoplasia stage 2+ after loop electrosurgical excision.

Gynecol Oncol 2020 Jun 22. Epub 2020 Jun 22.

The Center for Cervical disease, Shanghai Key Laboratory of Embryo Original Diseases, International Peace Maternity and Child Health Hospital affiliated to Shanghai Jiao Tong University School of Medicine, China. Electronic address:

Objective: To assess the value of endocervical curettage (ECC) during follow-up for patients with cervical intraepithelial neoplasia (CIN2+) after loop electrosurgical excision procedures (LEEP) and to explore risk factors for positive ECC during this evaluation.

Methods: There were 383 CIN2+ patients in the one-step method group who underwent LEEP and were prospectively followed up using ECC as a routine strategy, with colposcopy and liquid-based cytology (LCT) + human papilloma virus (HPV) co-testing performed. The finding were then compared with those from 1041 patients in the retrospective database who underwent colposcopy unless LCT and/or HPV screening was abnormal, and ECC was performed depending on colposcopy images (two-step method group). Read More

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http://dx.doi.org/10.1016/j.ygyno.2020.06.490DOI Listing

Syringe or mask? Loop electrosurgical excision procedure under local or general anesthesia: a randomized trial.

Am J Obstet Gynecol 2020 Jul 24. Epub 2020 Jul 24.

Department of Obstetrics and Gynecology, Ruhr-Universität Bochum, Bochum, Germany.

Background: Loop electrosurgical excision procedure may be performed under local anesthesia or general anesthesia, and practice patterns differ worldwide. No randomized head-to-head comparison has been published to confirm or refute either practice.

Objective: This study aimed to compare loop electrosurgical excision procedure under local anesthesia vs general anesthesia regarding patient satisfaction and procedure-related outcomes such as rates of involved margins, complications, pain, and blood loss. Read More

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http://dx.doi.org/10.1016/j.ajog.2020.06.041DOI Listing

Accuracy and Efficiency of Deep-Learning-Based Automation of Dual Stain Cytology in Cervical Cancer Screening.

J Natl Cancer Inst 2020 Jun 25. Epub 2020 Jun 25.

Steinbeis Transfer Center for Medical Systems Biology, Heidelberg, Germany.

Background: With the advent of primary human papillomavirus testing followed by cytology for cervical cancer screening, visual interpretation of cytology slides remains the last subjective analysis step and suffers from low sensitivity and reproducibility.

Methods: We developed a cloud-based whole-slide imaging platform with a deep-learning classifier for p16/Ki-67 dual-stained (DS) slides trained on biopsy-based gold standards. We compared it with conventional Pap and manual DS in 3 epidemiological studies of cervical and anal precancers from Kaiser Permanente Northern California and the University of Oklahoma comprising 4253 patients. Read More

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http://dx.doi.org/10.1093/jnci/djaa066DOI Listing

Evaluation of the concordance in HPV type between self- and physician-collected samples using a brush-based device and a PCR-based HPV DNA test in Japanese referred patients with abnormal cytology or HPV infection.

Int J Clin Oncol 2020 Jun 24. Epub 2020 Jun 24.

Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Fukui, 910-1193, Japan.

Background: To adopt HPV self-sampling in Japan, we assessed the concordance between self- and physician-collected human papillomavirus (HPV) samples from Japanese patients and examined the performance of HPV self-sampling for cervical intraepithelial neoplasia grade 2 or worse (CIN2+).

Methods: Patients who had previously tested negative for intraepithelial lesions or malignancy/HPV-positive, and patients with atypical squamous cells of undetermined significance or worse (ASCUS+) cytology were eligible for this cross-sectional study. Participants performed HPV self-sampling using an Evalyn brush, which was submitted at the Fukui Prefectural Health Care Association. Read More

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http://dx.doi.org/10.1007/s10147-020-01727-5DOI Listing

P16/Ki-67 Immunostaining in the Triage of Postmenopausal Women With Low-Grade Cytology Results.

J Low Genit Tract Dis 2020 Jul;24(3):235-237

Department for Pathology and Cytology, General Hospital Celje, Celje, Slovenia.

Objective: The interpretation of postmenopausal smears and the gynecological treatment of these patients can often be difficult. The objective of this study was to assess the performance of p16/Ki-67 dual-stained cytology as a triage of atypical squamous cells of undetermined significance and low-grade intraepithelial lesion cytology results in postmenopausal women.

Methods: All consecutive atypical squamous cells of undetermined significance and low-grade intraepithelial lesion smears in 1-year period were collected and p16/Ki-67 immunostaining was performed retrospectively. Read More

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http://dx.doi.org/10.1097/LGT.0000000000000539DOI Listing

Do High Rates of Atypical Glandular Cells Correlate With Higher Incidence of Disease in a Large Safety Net Hospital.

J Low Genit Tract Dis 2020 Jun 17. Epub 2020 Jun 17.

Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA.

Objective: The aim of the study was to describe the incidence and correlates of atypical glandular cell (AGC) Pap tests in a low socioeconomic status, underserved population.

Materials And Methods: Medical records of patients with AGC Pap tests at a single institution were reviewed from January 2013 to August 2019. Baseline characteristics were extracted including age, body mass index, birth control, abnormal uterine bleeding, and human papillomavirus (HPV). Read More

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http://dx.doi.org/10.1097/LGT.0000000000000556DOI Listing
June 2020
1.110 Impact Factor

HPV Catch-up Vaccination Reduces the Prevalence of HPV 16 and 18 Infections and Cervical Disease: A Retrospective Study.

J Low Genit Tract Dis 2020 Jun 18. Epub 2020 Jun 18.

Colposcopy Clinic Women's Outpatients Cumberland Infirmary Carlisle, England, United Kingdom Manchester Cytology Centre Division of Laboratory Medicine Manchester University NHS Foundation Trust Manchester, United Kingdom.

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http://dx.doi.org/10.1097/LGT.0000000000000550DOI Listing

The Performance of Immunocytochemistry Staining as Triaging Tests for High-Risk HPV-Positive Women: A 24-Month Prospective Study.

J Oncol 2020 26;2020:6878761. Epub 2020 May 26.

Department of Gynecology Oncology, Chongqing University Cancer Hospital, Chongqing 400030, China.

It is urgent to develop an accurate approach to improve the predictive performance of hrHPV-based screening. The aim is to evaluate the performance of p16/Ki-67 and p16/MCM2 staining to triage high-risk human papillomavirus- (hrHPV-) positive women. Cervical specimens were collected from eligible women and tested for hrHPV genotyping, cytology, p16/Ki-67, and p16/MCM2 staining at baseline. Read More

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http://dx.doi.org/10.1155/2020/6878761DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7271243PMC

Comparison of pain and proper sample status according to usage of tenaculum and analgesia: a randomized clinical trial.

Obstet Gynecol Sci 2020 Jul 19;63(4):506-513. Epub 2020 Jun 19.

Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Medipol University Mega Hospital, Istanbul, Turkey.

Objective: Colposcopic biopsy is a discomfortable procedure. Additionally, it creates negative influence on sexuality. This study aimed to investigate the relationships among tenaculum, pain perception, and biopsy size during colposcopy. Read More

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http://dx.doi.org/10.5468/ogs.19185DOI Listing

The effectiveness of HPV16 and HPV18 genotyping and cytology with different thresholds for the triage of human papillomavirus-based screening on self-collected samples.

PLoS One 2020 11;15(6):e0234518. Epub 2020 Jun 11.

Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, PR China.

Background/objective: Human papillomavirus (HPV) genotyping and cytology have been recommended for colposcopy triage, but it is unclear which combinations of high-risk HPV (hrHPV) types and cytology with various thresholds provide clinically useful information for the triage after primary HPV screening on self-collected samples.

Method: Chinese Multi-site Screening Trial (CHIMUST) database focused on self-collected samples was reviewed using the results of Cobas4800 HPV assay. Absolute risks of each genotype for cervical intraepithelial neoplasia 2 or worse/ 3 or worse (CIN2+/CIN3+) were calculated. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0234518PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7289398PMC

Benefit of double-reading cytology smears as a triage strategy among high-risk human papillomavirus-positive women in Mexico.

Cancer Cytopathol 2020 Jun 10. Epub 2020 Jun 10.

Centro de Investigación en Salud Poblacional. Instituto Nacional de Salud Pública, Cuernavaca, Mexico.

Background: The goal of this study was to determine whether the detection of histologically confirmed cases of cervical high-grade squamous intraepithelial lesions or worse (HSIL+) can be increased by having each liquid-based cytology (LBC) slide read by 2 cytotechnologists as part of routine screening.

Methods: Over 36,212 women aged 30 to 64 years participated in the Forwarding Research for Improved Detection and Access for Cervical Cancer Screening and Triage (FRIDA) Study in Mexico between 2013 and 2016. For each participant, 2 cervical samples were collected at the same clinic visit, one to test for high-risk human papillomavirus (hrHPV) and the other for LBC, which was used to triage those with a hrHPV positive result. Read More

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http://dx.doi.org/10.1002/cncy.22303DOI Listing

Correlation Between p16/Ki-67 Expression and the Grade of Cervical Intraepithelial Neoplasias.

Int J Gynecol Pathol 2020 Jul;39(4):384-390

Chittaranjan National Cancer Institute, Kolkata, West Bengal, India (R.M., I.G., D.B., S.M., C.R., C.P., M.V.) International Agency for Research on Cancer, Lyon, France (R.M., P.B.) CHU Dijon Bourgogne, Dijon, France (L.F.).

Interpretation of histopathology of cervical premalignant lesions suffers from marked interobserver variability due to its subjective nature. We aimed to evaluate the usefulness of the biomarkers p16 and Ki-67 in improving the diagnostic accuracy of cervical histopathology and assess the correlation between p16 expression and human papillomavirus test in different grades of cervical intraepithelial neoplasia (CIN). Cervical tissue specimens with a diagnosis of CIN 1 or worse (CIN 1+) on hematoxylin and eosin staining were selected for immunohistochemistry (IHC) staining for p16 and Ki-67. Read More

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http://dx.doi.org/10.1097/PGP.0000000000000617DOI Listing
July 2020
1.631 Impact Factor

Association of Low-Value Testing With Subsequent Health Care Use and Clinical Outcomes Among Low-risk Primary Care Outpatients Undergoing an Annual Health Examination.

JAMA Intern Med 2020 Jun 8. Epub 2020 Jun 8.

Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, Ontario, Canada.

Importance: The association of low-value testing with downstream care and clinical outcomes among primary care outpatients is unknown to date.

Objective: To assess the association of low-value testing with subsequent care among low-risk primary care outpatients undergoing an annual health examination (AHE).

Design, Setting, And Participants: This population-based retrospective cohort study used administrative health care claims from Ontario, Canada, for primary care outpatients undergoing an AHE between April 1, 2012, and March 31, 2016, to identify individuals who could be placed into one (or more) of the following 3 cohorts: adult patients (18 years or older) at low risk for cardiovascular and pulmonary disease, adult patients at low risk for cardiovascular disease, and female patients (aged 13-20 years or older than 69 years) at low risk for cervical cancer. Read More

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http://dx.doi.org/10.1001/jamainternmed.2020.1611DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7281357PMC

Implementing changes to cervical screening: A qualitative study with health professionals.

Aust N Z J Obstet Gynaecol 2020 Jun 8. Epub 2020 Jun 8.

Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.

Background: Profound changes were made to the Australian National Cervical Screening Program in December 2017, which included a reduction in the frequency of screening and a new cervical screening test.

Aim: To explore the attitudes and experiences of health professionals practising in Australia since implementation of these changes.

Materials And Methods: Thirty-one semi-structured interviews were conducted with general practitioners, obstetricians and gynaecologists, pathologists and nurses involved in cervical screening Australia-wide. Read More

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http://dx.doi.org/10.1111/ajo.13200DOI Listing

Cervical screening: ESGO-EFC position paper of the European Society of Gynaecologic Oncology (ESGO) and the European Federation of Colposcopy (EFC).

Br J Cancer 2020 Jun 8. Epub 2020 Jun 8.

Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, Hacettepe University Faculty of Medicine, Ankara, Turkey.

This paper summarises the position of ESGO and EFC on cervical screening based on existing guidelines and opinions of a team of lead experts. HPV test is replacing cytology as this offers greater protection against cervical cancer and allows longer screening intervals. Only a dozen of HPV tests are considered as clinically validated for screening. Read More

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http://dx.doi.org/10.1038/s41416-020-0920-9DOI Listing

Reflex cytology for triage of high-risk human papillomavirus positive self-sampled material in cervical cancer screening: a prospective cohort study.

BJOG 2020 Jun 7. Epub 2020 Jun 7.

Department of Pathology, Radboud university medical center, Nijmegen, The Netherlands.

Objective: High-risk human papillomavirus (HrHPV)-positive women detected by self-sampling require an extra visit at the general practitioner for additional cytology testing, but the loss to follow up within this triage is substantial. The aim of this study was to evaluate the clinical utility of reflex cytology on hrHPV-positive self-samples for immediate stratification of women who need referral for colposcopy.

Design: A prospective cohort study. Read More

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http://dx.doi.org/10.1111/1471-0528.16352DOI Listing

The value of microendoscopy in the diagnosis of cervical precancerous lesions and cervical microinvasive carcinoma.

Arch Gynecol Obstet 2020 Aug 5;302(2):455-462. Epub 2020 Jun 5.

Department of Obstetrics and Gynecology, East Hospital, Tongji University School of Medicine, Shanghai, China.

Purpose: Cervical cancer is still one of the main causes of death in females. Conventional diagnostic tools such as colposcopy are still unsatisfactory, so accurate diagnostic tools for cervical diseases are needed. Therefore, the purpose of this study was to perform a clinical study to evaluate the value of microendoscopic imaging systems in the diagnosis of cervical precancerous lesions and cervical microinvasive carcinoma (MIC). Read More

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http://dx.doi.org/10.1007/s00404-020-05565-8DOI Listing

Differences Between Squamous Intraepithelial Lesions of the Vulva and the Cervix.

J Low Genit Tract Dis 2020 Jul;24(3):330-331

University of Auckland, Auckland, NZ.

The Lower Anogenital Squamous Terminology project and subsequent publication have grouped preinvasive human papillomavirus-associated squamous intraepithelial lesions of the lower genital tract and adjacent skin as a single entity. We are concerned that as a result of this grouping, some of the clinically relevant differences may not be taken into consideration. We describe differences between high-grade squamous intraepithelial lesion of the vulva and cervix (vulvar intraepithelial neoplasia and cervical intraepithelial neoplasia), in embryology (arising from ectoderm vs mesoderm), clinical presentations (symptoms or signs due to many vulvar lesions vs abnormal cytology), examination techniques and diagnosis (clinical examination of potentially widely involved areas vs colposcopy of the transformation zone), natural history, management, and follow-up requirements (long-term clinical assessment vs cytology and human papillomavirus testing). Read More

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http://dx.doi.org/10.1097/LGT.0000000000000545DOI Listing