{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T16:06:54Z","timestamp":1771862814636,"version":"3.50.1"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["J Low Genit Tract Dis"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>Our aim was to evaluate the performance of different follow-up strategies after treatment for cervical intraepithelial neoplasia (CIN) 2 or 3, including human papillomavirus (HPV) detection, cytology, or colposcopy, as well as their combinations. Additionally, we compared the influence of the persistence of HPV 16\/18 versus that of other high-risk HPV genotypes (HR-HPV) in the recurrence risk.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Retrospective register-based study, including women who had an excision of the transformation zone for CIN2 or CIN3 at our institution, between January 2011 and December 2022. The outcome assessed was histopathological recurrence\/persistence of CIN2 or worse.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of the 721 women included, 6.8% (49\/721) had recurrence\/persistence. The sensitivity, specificity, and positive and negative predictive values of the HPV test were 97.4%, 80%, 22.3%, and 99.8%, respectively, whereas for cotesting (HR-HPV and cytology), 86.8%, 90.1%, 34.4%, and 99.1%, respectively. The referral rates for colposcopy were 24.3% and 14.2%, respectively. The sensitivity of colposcopy was low (40.0%).<\/jats:p>\n            <jats:p>Women who were initially positive for non-16\/18 genotypes at baseline who became HPV16\/18 positive during follow-up, had a statistically significant increased risk of CIN2 or worse, compared with those who tested positive only for other HR-HPV genotypes during both stages (hazard ratio = 4.98; 95% CI = 1.66\u201314.91).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Human papillomavirus testing is the best strategy for follow-up after treatment of cervical HSIL. The addition of cytology triage decreases by more than 40% the referrals for colposcopy, without significantly missing cases of recurrence\/persistence. Human papillomavirus 16\/18 in the follow-up, regardless of being previously positive, is associated with higher risk of recurrence\/persistence of HSIL.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/lgt.0000000000000803","type":"journal-article","created":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T14:00:44Z","timestamp":1710165644000},"page":"131-136","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Performance of Different Follow-Up Strategies and Genotype-Based Recurrence Risk After Treatment of Cervical High-Grade Squamous Intraepithelial Lesion"],"prefix":"10.1097","volume":"28","author":[{"given":"Joana","family":"Gra\u00e7a","sequence":"first","affiliation":[{"name":"Faculdade de Medicina da Universidade do Porto, Porto, Portugal"}]},{"given":"Mario","family":"Preti","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, University of Torino, Torino, Italy"}]},{"given":"Benedetta","family":"Pollano","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, University of Torino, Torino, Italy"}]},{"given":"Pedro","family":"Vieira-Baptista","sequence":"additional","affiliation":[]}],"member":"276","published-online":{"date-parts":[[2024,3,5]]},"reference":[{"key":"bib1-20250524","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1097\/LGT.0000000000000531","article-title":"An introduction to the 2019 ASCCP Risk-Based Management Consensus Guidelines","volume":"24","year":"2020","journal-title":"J Low Genit Tract Dis"},{"key":"bib2-20250524","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1097\/LGT.0000000000000525","article-title":"2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors","volume":"24","year":"2020","journal-title":"J Low Genit Tract Dis"},{"key":"bib3-20250524","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1136\/jclinpath-2013-202014","article-title":"Evaluation of commercial HPV assays in the context of post-treatment follow-up: Scottish Test of Cure Study (STOCS-H)","volume":"67","year":"2014","journal-title":"J Clin Pathol"},{"key":"bib4-20250524","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1097\/LGT.0000000000000693","article-title":"HPV test as test of cure after conization for CIN2+: a nationwide register-based cohort study","volume":"26","year":"2022","journal-title":"J Low Genit Tract Dis"},{"key":"bib5-20250524","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1097\/LGT.0000000000000526","article-title":"A systematic review of tests for postcolposcopy and posttreatment surveillance","volume":"24","year":"2020","journal-title":"J Low Genit Tract Dis"},{"key":"bib6-20250524","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/LGT.0000000000000708","article-title":"Recurrence in cervical high-grade squamous intraepithelial lesion: the role of the excised endocervical canal length\u2014analysis of 2,427 patients","volume":"27","year":"2023","journal-title":"J Low Genit Tract Dis"},{"key":"bib7-20250524","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1097\/LGT.0000000000000719","article-title":"Cervical high-grade squamous intraepithelial lesion burden and standard of care treatment effectiveness and safety in the United States, 2008\u20132018: the EACH-WOMAN project","volume":"27","year":"2023","journal-title":"J Low Genit Tract Dis"},{"key":"bib8-20250524","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/S1470-2045(11)70078-X","article-title":"Risk of recurrent high-grade cervical intraepithelial neoplasia after successful treatment: a long-term multi-cohort study","volume":"12","year":"2011","journal-title":"Lancet Oncol"},{"key":"bib9-20250524","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1007\/s00404-021-06217-1","article-title":"Risk factors associated with HPV persistence after conization in high-grade squamous intraepithelial lesion","volume":"304","year":"2021","journal-title":"Arch Gynecol Obstet"},{"key":"bib10-20250524","doi-asserted-by":"crossref","first-page":"698","DOI":"10.3390\/vaccines11030698","article-title":"Outcomes of high-grade cervical dysplasia with Positive Margins and HPV Persistence after Cervical Conization","volume":"11","year":"2023","journal-title":"Vaccines (Basel)"},{"key":"bib11-20250524","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1016\/S1470-2045(17)30700-3","article-title":"Incomplete excision of cervical precancer as a predictor of treatment failure: a systematic review and meta-analysis","volume":"18","year":"2017","journal-title":"Lancet Oncol"},{"key":"bib12-20250524","first-page":"e070135","article-title":"Role of human papillomavirus (HPV) vaccination on HPV infection and recurrence of HPV related disease after local surgical treatment: systematic review and meta-analysis","volume":"378","year":"2022","journal-title":"BMJ"},{"key":"bib17-20250524","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1097\/LGT.0b013e31825934c7","article-title":"2011 Terminology of the Vulva of the International Federation for Cervical Pathology and Colposcopy","volume":"16","year":"2012","journal-title":"J Low Genit Tract Dis"},{"key":"bib18-20250524","doi-asserted-by":"crossref","first-page":"e13606","DOI":"10.1097\/MD.0000000000013606","article-title":"Persistent HPV-16 infection leads to recurrence of high-grade cervical intraepithelial neoplasia","volume":"97","year":"2018","journal-title":"Medicine"},{"key":"bib19-20250524","doi-asserted-by":"crossref","first-page":"16865","DOI":"10.1038\/srep16865","article-title":"Cervical intraepithelial neoplasia disease progression is associated with increased vaginal microbiome diversity","volume":"5","year":"2015","journal-title":"Sci Rep"},{"key":"bib20-20250524","doi-asserted-by":"crossref","first-page":"e3","DOI":"10.3802\/jgo.2016.27.e3","article-title":"Posttreatment human papillomavirus testing for residual or recurrent high-grade cervical intraepithelial neoplasia: a pooled analysis","volume":"27","year":"2016","journal-title":"J Gynecol Oncol"},{"key":"bib21-20250524","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/j.ygyno.2012.01.015","article-title":"High-risk human papillomavirus testing versus cytology in predicting post-treatment disease in women treated for high-grade cervical disease: a systematic review and meta-analysis","volume":"125","year":"2012","journal-title":"Gynecol Oncol"},{"key":"bib22-20250524","doi-asserted-by":"crossref","first-page":"2542","DOI":"10.1200\/JCO.2016.71.4543","article-title":"Long-lasting increased risk of human papillomavirus\u2013related carcinomas and premalignancies after cervical intraepithelial neoplasia grade 3: a population-based cohort study","volume":"35","year":"2017","journal-title":"J Clin Oncol"},{"key":"bib23-20250524","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1186\/s12885-020-07452-6","article-title":"Risk of HPV-related extra-cervical cancers in women treated for cervical intraepithelial neoplasia","volume":"20","year":"2020","journal-title":"BMC Cancer"},{"key":"bib24-20250524","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.annonc.2019.11.004","article-title":"Incidence and mortality from cervical cancer and other malignancies after treatment of cervical intraepithelial neoplasia: a systematic review and meta-analysis of the literature","volume":"31","year":"2020","journal-title":"Ann Oncol"},{"key":"bib25-20250524","first-page":"91","article-title":"The International Society for the Study of Vulvovaginal Disease (ISSVD) Vulvar Awareness Day campaign: knowledge of vulvovaginal diseases among Italian obstetrics and gynecology residents","volume":"28","year":"2024","journal-title":"J Low Genit Tract Dis"},{"key":"bib26-20250524","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1016\/j.ejso.2023.01.025","article-title":"Positive pathological margins after loop electrosurgical excision procedure \u2013 management and outcome","volume":"49","year":"2023","journal-title":"Eur J Surg Oncol"},{"key":"bib27-20250524","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1097\/LGT.0000000000000527","article-title":"Reporting and assessing the quality of diagnostic accuracy studies for cervical cancer screening and management","volume":"24","year":"2020","journal-title":"J Low Genit Tract Dis"}],"container-title":["Journal of Lower Genital Tract Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/LGT.0000000000000803","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T20:01:01Z","timestamp":1748116861000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/LGT.0000000000000803"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,5]]},"references-count":23,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.1097\/lgt.0000000000000803","relation":{},"ISSN":["1526-0976"],"issn-type":[{"value":"1526-0976","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,5]]}}}