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Overtreatment in the see-and-treat approach for high-grade squamous cervical cytology.
Eur J Obstet Gynecol Reprod Biol X
September 2023
Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 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.
Identification of over- and undertreatment in the Dutch national cervical cancer screening program: A data linkage study at the hospital level.
Prev Med Rep
April 2023
Department of Health Economics, School of Business and Economics & Talma Institute, Vrije Universiteit, Amsterdam, the Netherlands.
Research into the quality of cancer screening programs often lacks the perspective of clinicians, missing insights into the performance of individual hospitals. This retrospective cohort study aimed to identify guideline deviation (specifically, overtreatment and undertreatment) related to the cervical cancer screening program in Dutch hospitals by deterministically linking nationwide insurance data with pathology data for cervical intraepithelial neoplasia (CIN). We then constructed quality indicators using the Dutch CIN guideline and National Health Care Institute recommendations to assess compliance with CIN management, treatment outcomes, and follow-up, using an empirical Bayes shrinkage model to correct for case-mix variation and hospitals with few observations.
View Article and Find Full Text PDFSingle step "See and Treat" strategy might be replacing the "conventional three step strategy" in management of preinvasive cervical lesions at tertiary center: A North Indian study.
J Cancer Res Ther
November 2022
Department of Obstetrics and Gynaecology, King George Medical University, Lucknow, Uttar Pradesh, India.
Introduction: The aim of this study was to compare overtreatment rates of see and treat colposcopy-based single step protocol with cytology and colposcopy-guided biopsy-based conventional three-step protocol using loop electrosurgical excision procedure (LEEP) for treatment of preinvasive lesions of cervix.
Materials And Methods: Prospective interventional study was carried out over a period of 1 year. Recruitment of cases was done from the 664 diagnostic colposcopies performed for various gynecological indications.
Overtreatment rate after immediate local excision of suspected cervical intraepithelial neoplasia: A prospective cohort study.
Gynecol Oncol
November 2022
Department of Obstetrics and Gynecology, University of Helsinki, Helsinki University Hospital, 00029 Helsinki, Finland; Department of Metabolism, Digestion and Reproduction - Surgery & Cancer, Faculty of Medicine, Imperial College London, W120NN, London, UK.
Objective: The gold standard of cervical intraepithelial neoplasia (CIN) treatment is large loop excision of the transformation zone (LLETZ) after histopathological diagnosis from punch biopsies. In addition, treatment may be appropriate at initial colposcopy. Our objective was to study the applicability of immediate treatment strategy according to clinical parameters.
View Article and Find Full Text PDFNegative histology in cervical specimens obtained with the "see and treat" method among women at a referral center in Rio de Janeiro, Brazil: a cross-sectional study.
BMC Womens Health
December 2021
Woman's Health Care Area, National Institute of Woman's, Child's and Adolescent's Health, Oswaldo Cruz Foundation, Av. Rui Barbosa, 716, Flamengo, Rio de Janeiro, RJ, CEP 22250-020, Brazil.
Background: According to the Brazilian Guidelines on Cervical Cancer Screening, women with cytopathologic diagnosis of high-grade intraepithelial lesion, abnormal colposcopic findings, fully visible squamocolumnar junction and age 25 years or older should be treated at the first visit ("see and treat-S&T"). The main limitation to this approach is the risk of overtreatment, identified by histology without preinvasive lesion. The objectives of this study were to identify the overtreatment rate in women undergoing S&T in cervical cancer prevention at a referral center with extensive experience with the method and to detect possible factors associated with this rate.
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