Adherence to the American Society for Colposcopy and Cervical Pathology guidelines: an observational study

Sarah Kay Conrad; Bassam Dahman; Anita Kumar; Jordan Hylton; Christine Isaacs

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자료유형: 학술저널

저자정보: Sarah Kay Conrad (Virginia Commonwealth University) Bassam Dahman (Virginia Commonwealth University) Anita Kumar (Virginia Commonwealth University) Jordan Hylton (Virginia Commonwealth University) Christine Isaacs (Virginia Commonwealth University)

저널정보: 대한산부인과학회 Obstetrics & Gynecology Science Obstetrics & Gynecology Science 제65권 제1호

발행연도: 2022.1

수록면: 84 - 93 (10page)

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ObjectiveThe 2012 American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines were developed to provideguidance regarding cervical pathology and to minimize overtreatment of lesions that may resolve spontaneously. Weaimed to evaluate the adherence to these guidelines with referrals for colposcopy at a large academic center and tounderstand the factors associated with incorrect referrals. MethodsThis retrospective observational study involved women referred to the Virginia Commonwealth University forcolposcopy or loop electrosurgical excision procedure from January 2015 to December 2016. ResultsReferral requests from 430 women were reviewed. Among these, 17.4% were discordant with the ASCCP guidelines. The most common discordant colposcopy referrals were low-grade squamous intraepithelial lesions (48%) and atypicalsquamous cells of undetermined significance (29%). The possibility of incorrect referrals was decreased among highgradelesions (odds ratio [OR], 0.03), while it was increased in women aged <25 years (OR, 31.6) and in those referredby family medicine (OR, 3.6) or internal medicine (OR, 4.4). Ten patients were referred for cervical cytology results ofsamples collected from the vaginal cuffs despite hysterectomies performed for benign lesions. ConclusionPatients referred outside of the guidelines were most often women aged <25 years with low-grade lesions. Referralsoutside evidence-based guidelines may lead to unnecessary procedures and additional healthcare expenses. Ourresults help identify the areas for provider education and potential areas of concern regarding the implementation ofthe 2019 ASCCP guideline updates.

#Retrospective studies #Colposcopy #Cervical intraepithelial neoplasia #Alphapapillomavirus #Squamous intraepithelial lesions

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