Analysis of Screening Women for Cervical Cancer Following an Excision for Cervical Intraepithelial Neoplasia [14E

Abstract

INTRODUCTION: This study assessed if the 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests can be successfully applied to a group of women who were treated with an excisional procedure for cervical dysplasia. METHODS: This retrospective longitudinal study encompassed all patients at an academic medical center who underwent an excisional procedure for cervical intraepithelial neoplasia from 2001 to 2013. We performed a comparative model analysis by applying the 2012 updated management and screening guidelines to a patient population that had previously undergone traditional screening. Our primary outcomes were identification of dysplasia recurrence and over-screening. We also identified characteristics associated with an increased risk of dysplasia recurrence. RESULTS: A total of 493 subjects contributed 505 specimens and 2247 subsequent pap smears to the final study population. Eighteen subjects (3.65%) underwent an intervention for recurrence. Compared to traditional screening, the 2012 management guidelines identified less recurrence (100% vs. 97.0%, P=0.001), but greatly reduced over-screening (39.2% vs 8.5%, P CONCLUSION: Application of the 2012 updated consensus guidelines to patients who have undergone an excisional procedure for cervical dysplasia results in a marginal decrease in identification of dysplasia recurrence which is balanced by a significant decrease in over-screening.