التفاصيل البيبلوغرافية
| العنوان: |
The 5-year risk of recurrence of grade 2/3 cervical intraepithelial neoplasia after treatment in a population screening programme by human papillomavirus status: A cohort study in central Italy. |
| المؤلفون: |
Visioli, Carmen Beatriz, Iossa, Anna, Gorini, Giuseppe, Mantellini, Paola, Lelli, Lisa, Auzzi, Noemi, Pierro, Carmelina Di, Carozzi, Francesca Maria, Zappa, Marco |
| المصدر: |
Journal of Medical Screening; Dec2023, Vol. 30 Issue 4, p191-200, 10p |
| مصطلحات موضوعية: |
TREATMENT of cervical intraepithelial neoplasia, PATIENT aftercare, CONFIDENCE intervals, CANCER relapse, RETROSPECTIVE studies, RISK assessment, DESCRIPTIVE statistics, KAPLAN-Meier estimator, CERVIX uteri tumors, DATA analysis software, TUMOR grading, LONGITUDINAL method, DISEASE risk factors |
| مصطلحات جغرافية: |
ITALY |
| مستخلص: |
Objectives: (a) To estimate the risk of recurrent cervical intraepithelial neoplasia, grade 2/3 or worse (CIN2+/CIN3+), lesions within 5 years of follow-up in human papillomavirus-negative/human papillomavirus-positive cohorts; (b) to assess whether certain risk factors can predict the recurrence of CIN2+/CIN3+ lesions; and (c) to provide recommendations for follow-up after treatment of cervical intraepithelial neoplasia, grade 2/3 to prevent cervical cancer. Setting: Organized cervical cancer screening programme in Central Italy. Methods: We included 1063 consecutive first excisional treatments performed between 2006 and 2014 for screening-detected cervical intraepithelial neoplasia, grade 2/3 lesions among women aged 25–65. The study population was divided into two groups according to the human papillomavirus test results performed 6 months after treatment: Human papillomavirus-negative and human papillomavirus-positive cohorts. The 5-year risk of developing cervical intraepithelial neoplasia, grade 2/3 or worse (CIN2+/CIN3+) was estimated using the Kaplan-Meier method and the Cox regression model. Results: Among 829 human papillomavirus-negative and 234 human papillomavirus-positive women, six (0.72%; three cervical intraepithelial neoplasia, grade 2, three cervical intraepithelial neoplasia, grade 3) and 45 (19.2%; 15 cervical intraepithelial neoplasia, grade 2, 30 cervical intraepithelial neoplasia, grade 3), respectively, developed CIN2+ recurrence within 5 years of follow-up. The cumulative risks for CIN2+ and CIN3+ were 0.9% (95% confidence interval: 0.4%–2.0%) and 0.5% (95% confidence interval: 0.1%–1.4%), respectively, for the human papillomavirus-negative cohort, and 24.8% (95% confidence interval: 18.5%–32.7%) and 16.9% (95% confidence interval: 11.4%–24.5%), respectively, for the human papillomavirus-positive cohort. Risk factors associated with increased risk of recurrence were both margins positive for the human papillomavirus-negative cohort, and positive margins, cervical intraepithelial neoplasia, grade 3 lesions, high-grade cytology and high viral load for the human papillomavirus-positive cohort. Conclusions: Human papillomavirus testing can identify women at increased risk of recurrence and this supports a recommendation for its use in the post-treatment follow-up of cervical intraepithelial neoplasia, grade 2/3 lesions. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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