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Is Colposcopy necessary at twelve months after large loop excision of the transformation zone? A clinical audit
Author(s) -
Thompson Valerie,
Marin Raymond
Publication year - 2013
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12153
Subject(s) - medicine , colposcopy , cervical intraepithelial neoplasia , papanicolaou stain , obstetrics , papanicolaou test , gynecology , cervical cancer , cancer
Objective The purpose of this study was to review outcomes from LLETZ (large loop excision of the transformation zone) procedures carried out for high‐grade cervical intraepithelial neoplasia ( CIN ), in particular findings at colposcopy, cytology and HR ‐ HPV (high‐risk human papilloma virus) result to assess whether colposcopy provides any additional information in the management of women at 12 months. Methods We retrospectively analysed 252 patients who had a LLETZ procedure for a HSIL (high‐grade squamous intraepithelial lesion) between January 2005 and December 2010. Results Eighty per cent of women who had a LLETZ procedure for HSIL were reviewed in our colposcopy clinic at 12 months after the procedure. Colposcopy at 12 months after LLETZ was documented as unsatisfactory for 30% of these women. The sensitivity of colposcopy at 12 months after LLETZ was 0.47, and the specificity was 0.95. Conclusion Colposcopy examination is an insensitive tool for detection of persisting HPV ‐related change after excision of high‐grade CIN . Its usefulness to investigate persistent or recurrent HSIL is further reduced by the high rate of unsatisfactory colposcopy examinations after a LLETZ procedure. Papanicolaou smear and HRHPV tests may be adequate follow‐up at 12 months after LLETZ for women at low risk of recurrence of HSIL .