Abstract
BackgroundAccording to the Brazilian Guidelines on Cervical Cancer Screening, women with cytopathologic diagnosis of high-grade intraepithelial lesion, abnormal colposcopic findings, fully visible squamocolumnar junction and age 25 years or older should be treated at the first visit (“see and treat—S&T”). The main limitation to this approach is the risk of overtreatment, identified by histology without preinvasive lesion. The objectives of this study were to identify the overtreatment rate in women undergoing S&T in cervical cancer prevention at a referral center with extensive experience with the method and to detect possible factors associated with this rate.MethodsThis was a cross-sectional study that analyzed records from a database with 616 women submitted to S&T from 1996 to 2017. Negative histology was defined as the following histopathologic results: human papillomavirus without cervical intraepithelial neoplasia (CIN), inflammatory, low-grade squamous intraepithelial lesion, and CIN 1.ResultsOf the 616 women, there were 52 (8.44%, 95%CI 6.25–10.64%) with a histopathologic report without preinvasive cervical lesion. No statistical association was found between this outcome and age or a significant downward trend over time.ConclusionThe overtreatment rate in this study can be considered low and consistent with the acceptable rates reported in the literature, reinforcing the prevailing Brazilian guideline, in which the benefits of immediate treatment outweigh the risk of losses following biopsy.
Highlights
According to the Brazilian Guidelines on Cervical Cancer Screening, women with cytopathologic diagnosis of high-grade intraepithelial lesion, abnormal colposcopic findings, fully visible squamocolumnar junction and age 25 years or older should be treated at the first visit (“see and treat—See and treat method (S&T)”)
According to the Brazilian Guidelines for Cervical Cancer Screening, women with high-grade squamous intraepithelial lesion (HSIL) and atypical squamous cells of undetermined significance in which it is not possible to rule out high-grade intraepithelial lesion (ASC-H) require immediate referral for colposcopy, due to the risk of invasive disease and possible need for treatment of a precursor lesion [2]
The results showed a slight downward trend in the probability of negative histology over the years, no statistical significance was found
Summary
According to the Brazilian Guidelines on Cervical Cancer Screening, women with cytopathologic diagnosis of high-grade intraepithelial lesion, abnormal colposcopic findings, fully visible squamocolumnar junction and age 25 years or older should be treated at the first visit (“see and treat—S&T”). According to the World Health Organization (WHO), a coverage of at least 80% of the target population and adequate diagnosis and treatment of identified cases would allow reducing in the incidence of invasive cervical cancer by 60–90% [1]. According to the Brazilian Guidelines for Cervical Cancer Screening, women with high-grade squamous intraepithelial lesion (HSIL) and atypical squamous cells of undetermined significance in which it is not possible to rule out high-grade intraepithelial lesion (ASC-H) require immediate referral for colposcopy, due to the risk of invasive disease and possible need for treatment of a precursor lesion [2]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
