{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T15:51:13Z","timestamp":1784562673860,"version":"3.55.0"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,7,14]],"date-time":"2015-07-14T00:00:00Z","timestamp":1436832000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Studies of see\u2010and\u2010treat management of cervical intraepithelial neoplasia (<jats:styled-content style=\"fixed-case\">CIN<\/jats:styled-content>) vary in their inclusion criteria, resulting in a broad range of overtreatment rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine overtreatment rates in see\u2010and\u2010treat management of women referred for colposcopy because of suspected <jats:styled-content style=\"fixed-case\">CIN<\/jats:styled-content>, in order to define circumstances supporting see\u2010and\u2010treat management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> EMBASE<\/jats:styled-content>, and the Cochrane Library were searched from inception up to 12\u00a0May\u00a02014.<\/jats:p><\/jats:sec><jats:sec><jats:title>Selection criteria<\/jats:title><jats:p>Studies of see\u2010and\u2010treat management in women with a reported cervical smear result, colposcopic impression, and histology result were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data collection and analysis<\/jats:title><jats:p>Methodological quality was assessed with the Newcastle\u2013Ottawa scale. We used the inverse variance method for pooling incidences, and a random\u2010effects model was used to account for heterogeneity between studies. Overtreatment was defined as treatment in patients with no <jats:styled-content style=\"fixed-case\">CIN<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">CIN<\/jats:styled-content>1.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>Thirteen studies (<jats:italic>n<\/jats:italic>\u00a0=\u00a04611) were included. The overall overtreatment rate in women with a high\u2010grade cervical smear and a high\u2010grade colposcopic impression was 11.6% (95%\u00a0<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 7.8\u201315.3%). The overtreatment rate in women with a high\u2010grade cervical smear and low\u2010grade colposcopic impression was 29.3% (95%\u00a0<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 16.7\u201341.9%), and in the case of a low\u2010grade smear and high\u2010grade colposcopic impression it was 46.4% (95%\u00a0<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 15.7\u201377.1%). In women with a low\u2010grade smear and low\u2010grade colposcopic impression, the overtreatment rate was 72.9% (95%\u00a0<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 68.1\u201377.7%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Author's conclusions<\/jats:title><jats:p>The pooled overtreatment rate in women with a high\u2010grade smear and high\u2010grade colposcopic impression is at least comparable with the two\u2010step procedure, which supports the use of see\u2010and\u2010treat management in this subgroup of women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>See\u2010and\u2010treat management is justified in the case of a high\u2010grade smear and a high\u2010grade colposcopic impression.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.13530","type":"journal-article","created":{"date-parts":[[2015,7,14]],"date-time":"2015-07-14T16:46:43Z","timestamp":1436892403000},"page":"59-66","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Evidence supporting see\u2010and\u2010treat management of cervical intraepithelial neoplasia: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"123","author":[{"given":"RMF","family":"Ebisch","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Radboud University Medical Center Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MM","family":"Rovers","sequence":"additional","affiliation":[{"name":"Department of Health Evidence Radboud University Medical Center Nijmegen the Netherlands"},{"name":"Department of Operating Rooms Radboud University Medical Center Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RP","family":"Bosgraaf","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Radboud University Medical Center Nijmegen the Netherlands"},{"name":"Department of Obstetrics and Gynaecology Jeroen Bosch Hospital 's\u2010Hertogenbosch the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HW","family":"van der Pluijm\u2010Schouten","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Radboud University Medical Center Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"WJG","family":"Melchers","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology Radboud University Medical Center Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PAJ","family":"van den Akker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Radboud University Medical Center Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LFAG","family":"Massuger","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Radboud University Medical Center Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RLM","family":"Bekkers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Radboud University Medical Center Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,7,14]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"FerlayJ SoerjomataramI ErvikM DikshitR EserS MathersC et\u00a0al.GLOBOCAN 2012\u00a0V1.0 Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11. 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