J Low Genit Tract Dis. 2018 Feb 23. doi: 10.1097/LGT.0000000000000373. [Epub
ahead of print]
Effect of High-Risk Human Papillomavirus but Normal Cytology at Test of Cure on
Achieving Colposcopy Standards.
Kalampokas E(1), Wilson J, Gurumurthy M, Cruickshank ME.
(1)Department of Gynaecologic Oncology, Aberdeen Royal Infirmary, Aberdeen,
OBJECTIVE: In United Kingdom., test of cure after treatment of any grade of
cervical intraepithelial neoplasia (CIN) incorporates high-risk human
papillomavirus (Hr-HPV) test and cytology at 6-month follow-up. The aims of the
study were to determine the rate of recurrent CIN in women who are Hr-HPV
positive and cytology negative and to explore possible associated risk factors.
METHODS: A retrospective observational cohort study was performed in women
treated for any grade CIN between 2010 and 2015 from a regional population, who
were Hr-HPV positive and cytology negative at first follow-up.
RESULTS: A total of 2729 women were identified as treated for any grade CIN, and
213 (7.8%) were re-referred to colposcopy having Hr-HPV-positive test and
negative cytology at test of cure. Their mean age was 31.56 years (range = 19-62
years). The mean time of follow-up per woman was 30.50 months (range = 2-63
months). At colposcopy, 171 (80.3%) had colposcopy examination only and 42 women
(19.7%) had a biopsy. Twenty-four cases (11.3%) of CIN were identified of which 4
(1.9%) were CIN 2/3. Eleven women (5.2%) in total had a repeat treatment. Five
women (2.3%) had biopsy-proven CIN 2/3 within 12-months after treatment. No cases
of CIN 3+ after negative colposcopy were identified during the follow-up period.
CONCLUSIONS: The incorporation of Hr-HPV testing yielded a very small number of
women with residual CIN within 12 months of treatment. Our results suggest that
women who are Hr-HPV positive and cytology negative after treatment of CIN with
normal and adequate colposcopy could be discharged to routine recall if confirmed
by larger national data.