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Colposcopy

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1. Immediate referral to colposcopy versus cytological surveillance for minor cervical cytological abnormalities in the absence of HPV test. (PubMed)

Immediate referral to colposcopy versus cytological surveillance for minor cervical cytological abnormalities in the absence of HPV test. A significant number of women are diagnosed with minor cytological abnormalities on cervical screening. Many authorities recommend surveillance as spontaneous regression might occur. However, attendance for cytological follow-up decreases with time and might put some women at risk of developing invasive disease.To assess the optimum management strategy (...) colposcopy to cytological surveillance in women with atypical squamous cells of undetermined significance (ASCUS/borderline) or low-grade squamous intra-epithelial lesions (LSIL/mild dyskaryosis).The primary outcome measure studied was the occurrence of cervical intra-epithelial neoplasia (CIN). The secondary outcome measures studied included default rate, clinically significant anxiety and depression, and other self-reported adverse effects.We classified studies according to period of surveillance, at 6

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2017 Cochrane

2. Video Colposcopy for Reducing Patient Anxiety During Colposcopy: A Randomized Controlled Trial

Video Colposcopy for Reducing Patient Anxiety During Colposcopy: A Randomized Controlled Trial To test whether video colposcopy reduces anxiety among patients undergoing colposcopy.In a prospective, randomized multicenter trial, we compared video colposcopy and no video colposcopy in a one-to-one ratio. Situation-specific anxiety was measured before (S1) and after (S2) colposcopy using the State-Trait Anxiety Inventory. The primary endpoint was the reduction of the situation-specific anxiety (...) scores (ΔS=S2-S1). Secondary endpoints were pain during and 10 minutes after colposcopy, general unpleasantness, anxiety during colposcopy, satisfaction with the information about the procedure, and overall satisfaction (11-item visual analog scales). Analysis was by intention to treat. A sample size of 104 per group (n=208) was planned to achieve 80% power to detect a difference of 4.8 with a SD of 12.3 in the primary outcome.Between August 2016 and March 2017, 225 women were randomized. The mean ΔS

2017 EvidenceUpdates

3. Pain relief for women with cervical intraepithelial neoplasia undergoing colposcopy treatment. (PubMed)

Pain relief for women with cervical intraepithelial neoplasia undergoing colposcopy treatment. Pre-cancerous lesions of cervix (cervical intraepithelial neoplasia (CIN)) are usually treated with excisional or ablative procedures. In the UK, the National Health Service (NHS) cervical screening guidelines suggest that over 80% of treatments should be performed in an outpatient setting (colposcopy clinics). Furthermore, these guidelines suggest that analgesia should always be given prior to laser (...) or excisional treatments. Currently various pain relief strategies are employed that may reduce pain during these procedures.To assess whether the administration of pain relief (analgesia) reduces pain during colposcopy treatment and in the postoperative period.We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 2), MEDLINE (1950 to March week 3, 2016) and Embase (1980 to week 12, 2016) for studies of any design relating to analgesia for colposcopic management. We also

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2016 Cochrane

4. Portable Pocket colposcopy performs comparably to standard-of-care clinical colposcopy using acetic acid and Lugol's iodine as contrast mediators - An investigational study in Perú. (PubMed)

Portable Pocket colposcopy performs comparably to standard-of-care clinical colposcopy using acetic acid and Lugol's iodine as contrast mediators - An investigational study in Perú. Our goal was to develop a tele-colposcopy platform for primary-care clinics to improve screening sensitivity and access. Specifically, we developed a low-cost, portable Pocket colposcope and evaluated its performance in a tertiary healthcare centre in Peru.Images of the cervix were captured with a standard-of-care (...) % and the sensitivity and specificity of physician interpretation compared with pathology by over 6.0 and 9.0%, respectively.The Pocket colposcope performance was similar to that of a standard-of-care colposcope when used to identify precancerous and cancerous lesions using acetic acid and Lugol's iodine during colposcopy examinations in Peru.The Pocket colposcope performance was similar to that of a standard-of-care colposcope when identifying cervical lesions.© 2018 Royal College of Obstetricians

2018 BJOG

5. Diagnostic accuracy of colposcopy with dynamic spectral imaging for cytology-negative/high-risk HPV positive (failed test of cure) after large loop excision of the transformation zone (LLETZ) of the cervix: Results of the DySIS colposcopy 1 study. (PubMed)

Diagnostic accuracy of colposcopy with dynamic spectral imaging for cytology-negative/high-risk HPV positive (failed test of cure) after large loop excision of the transformation zone (LLETZ) of the cervix: Results of the DySIS colposcopy 1 study. After treatment for cervical intraepithelial neoplasia (CIN), in the UK women who are cytology-negative, high-risk (HR) human papilloma virus (HPV) positive are referred to colposcopy. This pilot study assessed the incidence of residual/recurrent CIN (...) and the diagnostic accuracy of colposcopy with dynamic spectral imaging (DSI) mapping in their detection.This was a prospective service evaluation carried out in a UK National Health Service (NHS) colposcopy clinic. All women, referred with negative cytology/HR-HPV positive result following treatment for CIN from March 2013 until November 2014, who were examined with the DSI digital colposcope were included. We excluded 3 cases because of poor-quality imaging from user errors. Everyday clinical practice

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2018 Medicine

6. Closer to a Uniform Language in Colposcopy: Study on the Potential Application of 2011 International Federation for Cervical Pathology and Colposcopy Terminology in Clinical Practice (PubMed)

Closer to a Uniform Language in Colposcopy: Study on the Potential Application of 2011 International Federation for Cervical Pathology and Colposcopy Terminology in Clinical Practice As the newest colposcopic terminology, the 2011 International Federation for Cervical Pathology and Colposcopy (IFCPC) classification provides standardized interpretation of colposcopic findings. In this study, we analyzed the colposcopic accuracy and the significance of individual findings according to the 2011

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2017 BioMed research international

7. ASCCP Colposcopy Standards: Colposcopy Quality Improvement Recommendations for the United States (PubMed)

ASCCP Colposcopy Standards: Colposcopy Quality Improvement Recommendations for the United States The American Society for Colposcopy and Cervical Pathology (ASCCP) Colposcopy Standards recommendations address the role of and approach to colposcopy and biopsy for cervical cancer prevention in the United States. The recommendations were developed by an expert working group appointed by ASCCP's Board of Directors. The ASCCP Quality Improvement Working Group developed evidence-based guidelines (...) to promote best practices and reduce errors in colposcopy and recommended indicators to measure colposcopy quality.The working group performed a systematic review of existing major society and national guidelines and quality indicators. An initial list of potential quality indicators was developed and refined through successive iterative discussions, and draft quality indicators were proposed. The draft recommendations were then reviewed and commented on by the entire Colposcopy Standards Committee

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2017 Journal of lower genital tract disease

8. ASCCP Colposcopy Standards: How do we perform colposcopy? Implications for establishing standards (PubMed)

ASCCP Colposcopy Standards: How do we perform colposcopy? Implications for establishing standards The American Society for Colposcopy and Cervical Pathology (ASCCP) Colposcopy Standards recommendations address the role of and approach to colposcopy and biopsy for cervical cancer prevention in the United States. The recommendations were developed by an expert working group appointed by ASCCP's Board of Directors. Working group 3 defined colposcopy procedure guidelines for minimum (...) and comprehensive colposcopy practice and evaluated the use of colposcopy adjuncts.The working group performed a systematic literature review to identify best practices in colposcopy methodology and to evaluate the use of available colposcopy adjuncts. The literature provided little evidence to support specific elements of the procedure. The working group, therefore, implemented a national survey of current and recent ASCCP members to evaluate common elements of the colposcopy examination. The findings

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2017 Journal of lower genital tract disease

9. Adjunctive colposcopy technologies for assessing suspected cervical abnormalities: the DYSIS colposcope with DYSISmap and the ZedScan I

Adjunctive colposcopy technologies for assessing suspected cervical abnormalities: the DYSIS colposcope with DYSISmap and the ZedScan I Adjunctiv Adjunctive colposcop e colposcopy technologies for y technologies for assessing suspected cervical assessing suspected cervical abnormalities: the D abnormalities: the DYSIS colposcope YSIS colposcope with D with DYSISmap and the Z YSISmap and the ZedScan I edScan I Diagnostics guidance Published: 25 April 2018 nice.org.uk/guidance/dg32 © NICE 2018 (...) and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Adjunctive colposcopy technologies for assessing suspected cervical abnormalities: the DYSIS colposcope with DYSISmap and the ZedScan I (DG32) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 46Contents Contents

2018 National Institute for Health and Clinical Excellence - Diagnostics Guidance

10. Mozart for Reducing Patient Anxiety During Colposcopy: A Randomized Controlled Trial

Mozart for Reducing Patient Anxiety During Colposcopy: A Randomized Controlled Trial To test whether music by Mozart reduces anxiety among patients undergoing colposcopy.In a randomized multicenter trial, we measured the reduction of the situation-specific anxiety of women hearing Mozart's Symphony No. 40 during colposcopy compared with women not hearing music using the State-Trait Anxiety Inventory. Secondary endpoints were reduction of heart rate (beats per minute), pain during and 10 minutes (...) after colposcopy, general unpleasantness, anxiety during colposcopy, and overall satisfaction (11-item visual analog scales). Analysis was by intention to treat. A sample size of 104 per group (N=208) was calculated to achieve 80% power to detect a difference of 4.8 with a SD of 12.3 in anxiety scores.Between February 2017 and May 2018, 212 women were randomized. The mean anxiety reduction was -9.4±10.8 SD in 103 women in the music group and -9.0±10.6 in 102 women in the control group (P=.40

2018 EvidenceUpdates

11. Colposcopy and additive diagnostic value of biopsies from colposcopy-negative areas to detect cervical dysplasia. (PubMed)

Colposcopy and additive diagnostic value of biopsies from colposcopy-negative areas to detect cervical dysplasia. We evaluated colposcopy in the routine diagnostic workup of women with abnormal cervical cytology, as well as the diagnostic value of endocervical curettage material and biopsies taken from colposcopy-positive and colposcopy-negative quadrants of the cervix.This cross-sectional study included 297 nonpregnant women with abnormal cervical cytology and no prior treatment for cervical (...) dysplasia or cancer. All women underwent gynecological examination, colposcopy, endocervical curettage, and had cervical biopsies taken. Colposcopy was considered satisfactory if the squamocolumnar junction was fully visible, and biopsies were taken from all four quadrants of the cervix, regardless of colposcopy results.In all, 130 of the women in our study had satisfactory colposcopy results and were diagnosed with cervical intraepithelial neoplasia grade 2 or worse (CIN2+), 61% via a colposcopy

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2016 Acta Obstetricia et Gynecologica Scandinavica

12. MiRNA detection in cervical exfoliated cells for missed high-grade lesions in women with LSIL/CIN1 diagnosis after colposcopy-guided biopsy. (PubMed)

MiRNA detection in cervical exfoliated cells for missed high-grade lesions in women with LSIL/CIN1 diagnosis after colposcopy-guided biopsy. Low-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia grade 1 (LSIL/CIN1) preceded by colposcopy guided biopsy is recommended conservative follow-up, although some of these lesions are actually high-grade lesions, which are missed on an initial colposcopy. Therefore, in this work, we evaluate the potential role of miRNA detection (...) in cervical exfoliated cells in a clinic-based population for predicting missed high-grade lesions in women diagnosed with LSIL/CIN1 after colposcopy-guided biopsy.A total number of 177 women with a diagnosis of LSIL/CIN1 obtained by colposcopy-guided biopsy were grouped into two categories according to the histology of the conization specimens: consistent LSIL/CIN1 group (surgical pathology consistent with colposcopic diagnosis) and missed high-grade lesion group (surgical pathology found high-grade

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2019 BMC Cancer

13. Management and treatment of cervical intraepithelial neoplasia in the Netherlands after referral for colposcopy. (PubMed)

Management and treatment of cervical intraepithelial neoplasia in the Netherlands after referral for colposcopy. The aim of this study was to describe trends in the diagnosis and treatment of women referred from the national screening program with cervical intraepithelial neoplasia (CIN) in the Netherlands, and to compare these trends with national guidelines and identify potential areas for improvement for the new primary high-risk HPV screening program.We conducted a population-based cohort (...) study using data from the Dutch pathology archive. Women aged 29-63 years who took part in the Dutch cervical screening program between 1 January 2005 and 31 December 2014 were selected. Three referral groups were identified: direct referrals and those referred after either one (first indirect referrals) or two (second indirect referrals) repeat cytology tests, totaling 85 239 referrals for colposcopy. The most invasive management technique and the most severe diagnosis of each screening episode

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2019 Acta Obstetricia et Gynecologica Scandinavica

14. Prospective cohort study examining cervical cancer screening methods in HIV-positive and HIV-negative Cambodian Women: a comparison of human papilloma virus testing, visualization with acetic acid and digital colposcopy. (PubMed)

Prospective cohort study examining cervical cancer screening methods in HIV-positive and HIV-negative Cambodian Women: a comparison of human papilloma virus testing, visualization with acetic acid and digital colposcopy. Logistical and economic issues make traditional cytology-based cervical cancer screening challenging in developing countries. Alternative, cost-effective, screening strategies must be developed to screen millions of women in resource-poor countries such as Cambodia.A (...) prospective cohort study during which all women underwent four cervical cancer screening methods: (1) self-sampled human papilloma virus (HPV) testing (careHPV system), (2) clinician-collected HPV testing, (3) visualization with acetic acid (VIA) and (4) digital colposcopy (DC) with the Enhanced Visual Assessment System (EVA).A referral hospital in Phnom Penh, Cambodia.Two hundred and fifty Cambodian women (129 HIV+, 121 HIV-). Subjects were recruited from the National Center for HIV/AIDS Dermatology

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2019 BMJ open

15. Mozart for Reducing Patient Anxiety During Colposcopy: A Randomized Controlled Trial. (PubMed)

Mozart for Reducing Patient Anxiety During Colposcopy: A Randomized Controlled Trial. 30575664 2018 12 21 1873-233X 133 1 2019 Jan Obstetrics and gynecology Obstet Gynecol Mozart for Reducing Patient Anxiety During Colposcopy: A Randomized Controlled Trial. 191 10.1097/AOG.0000000000003052 Quinlan Maura Parker MP Department of Obstetrics and Gynecology, Northwestern University School of Medicine, Chicago, Illinois La Grange Park, Illinois. Quinlan John J JJ eng Journal Article United States

2019 Obstetrics and Gynecology

16. Cross-sectional study of HPV testing in self-sampled urine and comparison with matched vaginal and cervical samples in women attending colposcopy for the management of abnormal cervical screening. (PubMed)

Cross-sectional study of HPV testing in self-sampled urine and comparison with matched vaginal and cervical samples in women attending colposcopy for the management of abnormal cervical screening. Human papillomavirus (HPV) testing in cervical screening offers the potential for self-sampling to improve uptake among non-attenders. High-risk (HR) HPV detection in urine shows promise, but few studies have examined its sensitivity for cervical intraepithelial neoplasia (CIN2+) detection compared (...) with standard cervical samples. The aims of this cross-sectional study were to optimise conditions for urine testing for HPV detection; to determine concordance for HR-HPV detection in matched urine, vaginal and cervical samples; to compare the sensitivity of HR-HPV testing for the detection of CIN2+ in matched samples; and to determine the acceptability of urine testing for cervical screening.Cross-sectional study.Secondary care colposcopy clinic in North West England.Women aged 25 years of age or older

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2019 BMJ open

17. The impact of decentralising colposcopy services from tertiary-level to primary-level care in inner-city Johannesburg, South Africa: a before and after study. (PubMed)

The impact of decentralising colposcopy services from tertiary-level to primary-level care in inner-city Johannesburg, South Africa: a before and after study. To assess whether decentralising colposcopy services to a primary care facility in inner-city Johannesburg, South Africa raises access to colposcopy.Before-after study comparing 2 years before and 2 years after decentralisation, using clinical records and laboratory data on cervical cytology and histology.The proportion of all women (...) attending Hillbrow Community Health Centre (HCHC) with an abnormal Papanikolaou (Pap) smear who had a colposcopy post-decentralisation.Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) has provided colposcopy services for several decades. HCHC, located about 3 km away, began colposcopy services in 2014.Women, aged above 18 years, who had a colposcopy for diagnosis and treatment of precancerous cervical lesions following a Pap smear, from 2012 to 2016 at CMJAH or HCHC.Pre-decentralisation at CMJAH

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2019 BMJ open

18. HPV OncoTect? E6, E7 mRNA assay to guide colposcopy referral in cervical cancer screening

HPV OncoTect? E6, E7 mRNA assay to guide colposcopy referral in cervical cancer screening HPV OncoTect™ E6, E7 mRNA assay to guide colposcopy referral in cervical cancer screening HPV OncoTect™ E6, E7 mRNA assay to guide colposcopy referral in cervical cancer screening Australian Safety and Efficacy Register of New Interventional Procedures -Surgical (ASERNIP-S) Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation (...) of the quality of this assessment has been made for the HTA database. Citation Australian Safety and Efficacy Register of New Interventional Procedures -Surgical (ASERNIP-S). HPV OncoTect™ E6, E7 mRNA assay to guide colposcopy referral in cervical cancer screening . Australia: Australian Safety and Efficacy Register of New Interventional Procedures -Surgical (ASERNIP-S). Technology Brief. 2014 Authors' objectives The HPV OncoTect™ E6, E7 mRNA assay is a new test for the early detection of cervical cancer

2014 Health Technology Assessment (HTA) Database.

19. Follow-up of ASCUS or LSIL: Colposcopy vs repeat cytology

Follow-up of ASCUS or LSIL: Colposcopy vs repeat cytology Follow-up of ASCUS or LSIL: Colposcopy vs repeat cytology – Less Is More Search for: Simpler & Better Medicine Menu / Summary: For women between 22 to 27 years of age who have a pap test showing atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL), following up with repeat cervical cytology at 6 months may be associated with the same rates of invasive cervical cancer at 6.5 (...) years as following up with colposcopy and biopsy at 6 months, at potentially lower cost. Strength of Recommendation = C Advertisements Like this: Like Loading... Categories: Post navigation Simpler, Better Medicine Indexing evidence for "less medical” approaches with better outcomes. Recent entries Search by key words Search for: Search By Strength of Recommendation (SOR) (42) (244) (27) Search by clinical category For regular updates, follow "Less-Is-More" by Email, RSS, or on Wordpress Follow

2017 Less Is More Blog

20. Effect of lidocaine spray during colposcopy-directed cervical biopsy: A randomized controlled trial. (PubMed)

Effect of lidocaine spray during colposcopy-directed cervical biopsy: A randomized controlled trial. We aimed to examine the effect of lidocaine spray in reducing pain during colposcopy-directed cervical biopsy (CDB).Two hundred women with abnormal cervical screening test results and abnormal colposcopic findings that required a CDB during April to December 2015 were enrolled. The participants were randomly assigned into one of two groups. For group 1 (lidocaine group), 10% lidocaine spray (...) in the no-anesthesia group (group 2), P = 0.01 and P = 0.02, respectively. However, the degree of pain was minimal in both groups. There were no complications observed in any participants.Lidocaine spray reduces pain during colposcopy-directed cervical biopsy; however, the clinically meaningful effect of such a procedure cannot be demonstrated in this study.© 2017 Japan Society of Obstetrics and Gynecology.

2018 The journal of obstetrics and gynaecology research

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