The Prevalence of High Grade Cervical Intraepithelial Neoplasia (CIN) in a Primary Human Papillomavirus (HPV) Cervical Screening Programme Population with HPV Positive and Cytology Negative Smear Results

作     者：Simon G. Williams Ayesha Anwar Sachinta G. Wijesiri Sangeetha Palaparthy Emma Winter Simon G. Williams;Ayesha Anwar;Sachinta G. Wijesiri;Sangeetha Palaparthy;Emma Winter

作者机构：Specialty Trainee in O&G South Tyneside and Sunderland NHS Foundation Trust Sunderland UK Consultant Obstetrician and Gynaecologist North Cumbria Integrated Care NHS Foundation Trust Carlisle UK Specialty Trainee in O&G County Durham and Darlington NHS Foundation Trust Durham UK Specialty Trainee in O&G Queen Elizabeth University Hospital Glasgow UK Specialty Doctor in Gynaecology and Colposcopy Services North Cumbria Integrated Care NHS Trust Carlisle UK 

出 版 物：《Open Journal of Obstetrics and Gynecology》 (妇产科期刊（英文）)

年 卷 期：2020年第10卷第7期

页      面：902-908页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Cervical Screening Cervical Intraepithelial Neoplasia Cervical Cancer Human Papillomavirus Colposcopy 

摘      要：High-risk HPV is found in 99.7% of cervical cancers. The causative role of HPV in cervical cancer has led to the inclusion of HPV testing as part of cervical screening. A pilot of HPV testing as primary screening was commenced in 2013 at six pilot sites in England. North Cumbria Integrated Care (NCIC) NHS Foundation Trust took part in the pilot, in which women with an HPV-positive/cytology-negative result were recalled at 12 months. Women with HPV type 16/18 found at initial screening and persisting at 12 months in spite of negative cytology were referred to Colposcopy services at 12 months. Women with smear positive for hrHPV other than 16/18 types were recalled twice at 12 and 24 months before referral to colposcopy. Persistent hrHPV positive/cytology negative smear at 12 and 24 months initiated a colposcopy referral. Objective: To assess the prevalence of high grade CIN and invasive cancer in patients referred to colposcopy services at NCIC NHS Foundation Trust with hrHPV positive/cytology negative smears. Method: The study was conducted at NCIC NHS Foundation Trust between January 2015 and December 2017. Data was collected retrospectively from the colposcopy data base (INFOFLEX). All patients with HPV positive/cytology negative smears seen in colposcopy clinic during the study period were included. Patients with high grade CIN, cervical glandular intraepithelial neoplasia (CGIN) or invasive cancer were recorded. Results: 763 women were included in the study. A total of 50 (6.6%) women had high grade CIN, CGIN or invasive cancer. 40 of these 50 women (80%) were treated by large loop excision of the transformation zone (LLETZ).