Overtreatment in the see-and-treat approach for high-grade squamous cervical cytology
1
Issued Date
2023-09-01
Resource Type
eISSN
25901613
Scopus ID
2-s2.0-85161622022
Journal Title
European Journal of Obstetrics and Gynecology and Reproductive Biology: X
Volume
19
Rights Holder(s)
SCOPUS
Bibliographic Citation
European Journal of Obstetrics and Gynecology and Reproductive Biology: X Vol.19 (2023)
Suggested Citation
Rongthongaram W., Plumworasawat S., Charakorn C., Lertkhachonsuk A.A., Satitniramai S. Overtreatment in the see-and-treat approach for high-grade squamous cervical cytology. European Journal of Obstetrics and Gynecology and Reproductive Biology: X Vol.19 (2023). doi:10.1016/j.eurox.2023.100205 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/87141
Title
Overtreatment in the see-and-treat approach for high-grade squamous cervical cytology
Author's Affiliation
Other Contributor(s)
Abstract
Objectives: To evaluate overtreatment with the ‘see-and-treat’ approach in patients with high-grade squamous cervical cytology, and identify the clinical factors associated with overtreatment. Study design: Patients with high-grade squamous intra-epithelial lesion (HSIL) cytology undergoing colposcopy and loop electrosurgical excision procedure (LEEP) in a single visit or the ‘see-and-treat’ approach from January 2005 to December 2019 were reviewed retrospectively. The overtreatment rate and complications following LEEP were explored. Results: In total, 220 cases were identified. The overtreatment rate was 11.4%, and surgical complications were haemorrhage (n = 3, 1.36%) and infection (n = 9, 4.09%). On univariable analysis, factors associated with overtreatment were current cytological result and colposcopic impression. On multi-variable analysis, current cytological result of non-HSIL compared with HSIL/cancer, and colposcopic diagnosis of low-grade lesion or normal compared with high-grade lesion or cancer had adjusted odds ratios of 13.81 [95% confidence interval (CI) 1.23–155.20; p = 0.033] and 3.58 (95% CI 1.32–9.74; p = 0.013), respectively. Conclusions: The overtreatment rate with the ‘see-and-treat’ approach was 11.4%. Independent factors associated with overtreatment were current cervical cytological result of non-HSIL, and low-grade or normal colposcopic diagnosis.