Journal article
A Systematic Review of Tests for Postcolposcopy and Posttreatment Surveillance
Journal of lower genital tract disease, Vol.24(2), pp.148-156
04/01/2020
DOI: 10.1097/LGT.0000000000000526
PMCID: PMC7141755
PMID: 32243310
Abstract
Objective
For the 2019 ASCCP Risk-Based Management Consensus Guidelines, we conducted a systematic review of diagnostic assays for postcolposcopy and posttreatment management. Materials and Methods
A literature search was conducted to identify articles reporting on tests/assays for cervical cancer screening, triage, postcolposcopy surveillance, and posttreatment surveillance published between 2012 and 2019 in PubMed and Embase. Titles and abstracts were evaluated by co-authors for inclusion. Included articles underwent full-text review, data abstraction, and quality assessment. Pooled absolute pretest and posttest risk estimates were calculated for studies evaluating management of patients after treatment. Results
A total of 2,862 articles were identified through the search. Of 50 articles on postcolposcopy, 5 were included for data abstraction. Of 66 articles on posttreatment, 23 were included for data abstraction and were summarized in the meta-analysis. The pooled posttreatment risk of cervical intraepithelial neoplasia (CIN) 2+ in all studies was 4.8% (95% CI = 3.4%-6.8%), ranging from 0.4%-19.5% (tau(2) = 0.57) in individual studies. Among individuals testing negative for human papillomavirus (HPV) posttreatment, the risk of CIN 2+ was 0.69% (95% CI = 0.3%-1.5%); among individuals testing positive for HPV posttreatment, the risk of CIN 2+ was 18.3% (95% CI = 12.1%-26.6%) in all studies. All risk estimates were substantially higher for liquid-based cytology. The HPV-cytology co-testing provided slightly better reassurance compared with HPV alone at the cost of much higher positivity. Conclusions
Despite a large number of published studies on postcolposcopy and posttreatment surveillance, only few met criteria for abstraction and were included in the meta-analysis. More high-quality studies are needed to evaluate assays and approaches that can improve management of patients with abnormal screening.
Details
- Title: Subtitle
- A Systematic Review of Tests for Postcolposcopy and Posttreatment Surveillance
- Creators
- Megan A. Clarke - Division of Cancer Epidemiology & Genetics, National Cancer Institute/NIH, Bethesda, MD.Elizabeth R. Unger - (Centers for Disease Control, Atlanta, GaRosemary Zuna - University of OklahomaErin Nelson - The University of Texas at San AntonioTeresa M. Darragh - University of California, San FranciscoMiriam Cremer - Cleveland ClinicColleen K. Stockdale - Roy J. and Lucille A. Carver College of MedicineMark H. Einstein - Rutgers, The State University of New JerseyNicolas Wentzensen - Division of Cancer Epidemiology & Genetics, National Cancer Institute/NIH, Bethesda, MD.
- Resource Type
- Journal article
- Publication Details
- Journal of lower genital tract disease, Vol.24(2), pp.148-156
- DOI
- 10.1097/LGT.0000000000000526
- PMID
- 32243310
- PMCID
- PMC7141755
- NLM abbreviation
- J Low Genit Tract Dis
- ISSN
- 1089-2591
- eISSN
- 1526-0976
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 9
- Grant note
- Z01CP010124-21 / Intramural Research Program of the National Cancer Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) ASCCP
- Language
- English
- Date published
- 04/01/2020
- Academic Unit
- Obstetrics and Gynecology
- Record Identifier
- 9984318228302771
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