{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:36:02Z","timestamp":1787164562170,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T00:00:00Z","timestamp":1743206400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2021YFC2701202"],"award-info":[{"award-number":["2021YFC2701202"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["U20A20368"],"award-info":[{"award-number":["U20A20368"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study was conducted to identify the risk of residual or recurrent high\u2010grade squamous intraepithelial lesions or worse (HSIL+) in patients with successful conization and to develop a customized management strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 939 patients who underwent cold knife conization (CKC) for cervical intraepithelial neoplasia 3 at a hospital in China between January 1, 2013 and December 31, 2020. Demographic characteristics and test results were obtained before and 6, 12, and 24\u2009months after CKC and annually thereafter. Human papillomavirus (HPV) persistence was defined as HPV positive at both 6 and 12\u2009months after CKC, and the primary endpoint was residual or recurrent HSIL+ after CKC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean follow\u2010up period was 68.8\u2009months. In total, 61 (6.5%) patients had HPV persistence, and 19 (2.0%) had residual or recurrent HSIL+. The risk of residual or recurrent HSIL+ was increased in patients with HPV infection at 6\u2009months (hazard ratio [HR], 84.6; 95% confidence interval [CI], 11.2\u2013641) and 12\u2009months (HR, 214; 95% CI, 28.1\u20131625) after CKC, and HPV persistence after CKC (HR, 244; 95% CI, 32.2\u20131854). Comparing two different colposcopic referral criteria for HPV persistence and HPV positive 6\u2009months post\u2010CKC, substantially fewer colposcopies were performed per case of residual or recurrent HSIL+ detected in patients with HPV persistence after CKC (3.39 vs. 8.28).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The risk of residual or recurrent HSIL+ was higher in patients with HPV persistence after CKC. In patients with negative margins, extending the follow\u2010up interval to 12\u2009months may reduce the number of HPV tests and colposcopy referral rates while maintaining HSIL+ detection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.70825","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T08:08:27Z","timestamp":1743408507000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Optimizing the Follow\u2010Up Interval After Successful Cold Knife Conization of\n                    <scp>CIN3<\/scp>\n                    : A 10\u2010Year Retrospective Cohort Study"],"prefix":"10.1002","volume":"14","author":[{"given":"Kun","family":"Fu","sequence":"first","affiliation":[{"name":"Department of Gynecology Xiangya Hospital, Central South University  Changsha China"},{"name":"Gynecological Oncology Research and Engineering Center of Hunan Province  Changsha 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