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Title: Assessing the see-and-treat approach for the management of high-grade squamous intraepithelial cervical lesions
Authors: Xuereb, Sarah
Pavia, Jessica
Brincat, Mark R.
Tanti, Charmaine
Saliba, Isabelle
Keywords: Colposcopy
Cervix uteri -- Cancer -- Diagnosis
Cervix uteri -- Cancer -- Treatment
Medical overuse
Issue Date: 2019-12
Publisher: University of Malta. Medical School
Citation: Xuereb, S., Pavia, J., Brincat, M. R., Tanti, C., & Saliba, I. (2019). Assessing the see-and-treat approach for the management of high-grade squamous intraepithelial cervical lesions. Malta Medical Journal, 8(2), 2-7.
Abstract: Objectives: To assess local histological outcomes in patients with HSIL cytology results on cervical smears, in both the see-and-treat and three-step approach. Study Design: A retrospective analysis of patients with HSIL on cervical cytology was performed, obtaining an 83 patient cohort. The histological result following the primary investigation (colposcopic-directed biopsy or excisional procedure) was noted for each patient together with their demographic variables and HPV status. Results: Of 83 patients with HSIL cytology on cervical smear, 43 underwent LLETZ as a primary procedure, while 40 patients underwent a colposcopic-directed biopsy. There was no statistically significant difference in terms of dermographics and HPV status between the two groups. In those patients who had LLETZ as a primary procedure, 29 had CIN2+ on histology. On the other hand, following colposcopic-directed biopsies, 17 resulted in CIN2+ on histology. Conclusion: The conventional approach within our local setting potentially has inferior sensitivity in picking up CIN2+ lesions when compared to the see-and-treat approach. On the other hand, primary excisional procedures were associated with an overtreatment rate of at least 20.9%, subjecting patients to unnecessary risks. Local improvement of colposcopic skill will aid to reduce this overtreatment rate and missed lesions at biopsy.
Appears in Collections:MMJ, Volume 31, Issue 3
MMJ, Volume 31, Issue 3
Scholarly Works - FacM&SOG

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