{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T04:24:21Z","timestamp":1777868661989,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,11,9]],"date-time":"2017-11-09T00:00:00Z","timestamp":1510185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2017,11,9]],"date-time":"2017-11-09T00:00:00Z","timestamp":1510185600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl J Gynecology & Obste"],"published-print":{"date-parts":[[2018,2]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n \n To determine whether the grade of referral smear reflects the frequency of cervical intraepithelial neoplasia (\n CIN<\/jats:styled-content>\n ) grade 3 (\n CIN<\/jats:styled-content>\n 3) or worse lesions among patients with\n CIN<\/jats:styled-content>\n 2 on punch biopsy.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In a retrospective study, data were reviewed from women with a punch biopsy sample showing\n CIN<\/jats:styled-content>\n 2 and a known referral smear who underwent large loop excision of the transformation zone (\n LLETZ<\/jats:styled-content>\n ) between January 1, 2013, and January 1, 2016, at Galway University Hospital, Ireland. Data were analyzed by patient age (\u226430 and >30\u00a0years), referral smear (low and high grade), and\n LLETZ<\/jats:styled-content>\n histology (\u2264\n CIN<\/jats:styled-content>\n 2 and \u2265\n CIN<\/jats:styled-content>\n 3).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Overall, 264 women were included.\n LLETZ<\/jats:styled-content>\n histology of\n CIN<\/jats:styled-content>\n 3 or worse was more common among women with high\u2010grade referral smears (63\/144 [43.8%]) than among those with low\u2010grade smears (26\/120 [21.7%]; relative risk 2.02, 95% confidence interval 1.37\u20132.96;\n P<<\/jats:italic>\n 0.001). Among patients younger than 30\u00a0years, underlying\n CIN<\/jats:styled-content>\n 3 and above was again more frequent among women with high\u2010grade (44\/95 [46.3%]) versus low\u2010grade smears (12\/56 [21.4%]; relative risk 2.16, 95% confidence interval 1.25\u20133.73;\n P=<\/jats:italic>\n 0.004). No difference was recorded in the older age group.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Although\n LLETZ<\/jats:styled-content>\n can be performed for a\n CIN<\/jats:styled-content>\n 2 biopsy and high\u2010grade smear, consideration should be given among young women (<30\u00a0years) with low\u2010grade smears whose biopsy histology is incidentally\n CIN<\/jats:styled-content>\n 2.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/ijgo.12357","type":"journal-article","created":{"date-parts":[[2017,10,19]],"date-time":"2017-10-19T12:08:40Z","timestamp":1508414920000},"page":"223-227","source":"Crossref","is-referenced-by-count":0,"title":["Association between grade of referral smear and high\u2010grade disease among women with biopsy samples showing cervical intraepithelial neoplasia grade 2"],"prefix":"10.1002","volume":"140","author":[{"given":"Emmanuel","family":"Hakem","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology University College Hospital Galway Galway Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elzahra","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University College Hospital Galway Galway Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel","family":"Tanyous","sequence":"additional","affiliation":[{"name":"Ministry of Health General Directorate of Primary Health Care Central Supervision Unit Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharine","family":"Astbury","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University College Hospital Galway Galway Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikhil","family":"Purandare","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University College Hospital Galway Galway Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,11,9]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"World Health Organization International Agency for Research on Cancer.Cervical cancer: estimated incidence mortality and prevalence worldwide in 2012.http:\/\/globocan.iarc.fr\/old\/FactSheets\/cancers\/cervix-new.asp. Accessed October 16 2017."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.21731"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1039\/C3AY42224K"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2016.290"},{"key":"e_1_2_8_6_1","unstructured":"Public Health England.NHS Cervical Screening Programme: Colposcopy and Programme Management Public Health England.https:\/\/www.bsccp.org.uk\/assets\/file\/uploads\/resources\/NHSCSP_20_Colposcopy_and_Programme_Management_(3rd_Edition)_(2).pdf. Published March 2016. Accessed October 16 2017."},{"key":"e_1_2_8_7_1","first-page":"8","article-title":"The validation of cervical cytology. 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