Back to Search Start Over

Compliance with follow-up Test of Cure and outcomes after treatment for high-grade cervical intraepithelial neoplasia in Victoria, Australia.

Authors :
Tan JHJ
Malloy MJ
Brotherton JML
Saville M
Source :
The Australian & New Zealand journal of obstetrics & gynaecology [Aust N Z J Obstet Gynaecol] 2020 Jun; Vol. 60 (3), pp. 433-437. Date of Electronic Publication: 2020 Jan 16.
Publication Year :
2020

Abstract

Background: Test of Cure (ToC), a combination of testing for oncogenic human papillomavirus (HPV) and cytology, at 12 months post-treatment and annually thereafter, was approved in Australia in 2005 for follow-up of women treated for high-grade squamous intraepithelial lesions (HSIL) of the cervix.<br />Aims: To determine among women resident in Victoria, Australia, the compliance with ToC and the incidence of recurrence up to five years after successful ToC.<br />Materials and Methods: A retrospective analysis of women with HSIL (diagnosed at pre-treatment punch biopsy or at excision) who had excisional treatment between 1 January 2007 and 31 December 2011. De-identified data were retrieved from the Victorian Cervical Cytology Registry in Melbourne as at 24 April, 2015. Successful ToC is defined as the occurrence of two consecutive normal (negative) co-tests. Recurrence after treatment is defined by histologically detected HSIL or greater.<br />Results: There were 8478 women who had excisional treatment for HSIL, with 448 (5.5%) experiencing recurrence. Only 2253 (26.6%) women successfully completed ToC, with a decreasing likelihood of ToC completion by time since year of treatment (32.0% in 2007 compared with 20.9% in 2011). Only one (0.08%) woman had HSIL on histology after successful ToC. From the 2007 cohort, 555 (32.0%) women completed ToC successfully and no HSIL recurrence occurred thereafter (median subsequent follow-up period of 4.7 years).<br />Conclusions: Our study confirmed that women who successfully complete ToC can be returned to five-year routine screening. However, more concerted efforts are needed to ensure that all women treated complete ToC.<br /> (© 2020 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.)

Details

Language :
English
ISSN :
1479-828X
Volume :
60
Issue :
3
Database :
MEDLINE
Journal :
The Australian & New Zealand journal of obstetrics & gynaecology
Publication Type :
Academic Journal
Accession number :
31950488
Full Text :
https://doi.org/10.1111/ajo.13115