{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:36:37Z","timestamp":1747182997595,"version":"3.40.5"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T00:00:00Z","timestamp":1620000000000},"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":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>A renewed National Cervical Screening Program (NCSP) was introduced in Australia in December 2017. Under the renewed NCSP, there are limited data to guide the management of discordant colposcopy and biopsy results after a liquid\u2010based cytology (LBC) finding of \u2018possible high\u2010grade squamous intraepithelial lesion\u2019 (pHSIL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study aims to determine the proportion of women referred with pHSIL who are found to have HSIL, identify influencing factors of women most at risk, and examine the role that cytopathology review plays in management decisions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Two\u2010hundred and thirty\u2010two women presenting to a tertiary women\u2019s hospital in Australia with pHSIL since December 2017 were identified. Women with HSIL following colposcopy directed biopsy were referred for treatment. When HSIL was not identified, these patients were referred for multidisciplinary clinicopathological review. Pathological outcomes and treatment recommendations are included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>The primary outcome of the study was histological confirmation of HSIL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Primary outcome data were available for 182 women (78.5%); 62 (34.1%) had HSIL on histology, three (1.7%) had adenocarcinoma in situ (AIS) and one (1%) had cervical squamous cell carcinoma (SCC). There was no association between age and the presence of HSIL. The presence of human papillomavirus 16 and\/or 18 increased the likelihood of HSIL on histology (relative risk 1.9; 95% CI 1.27\u20132.80, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.002). Fifty\u2010nine (25.4%) women were referred for observation who had low\u2010grade squamous intraepithelial lesion\/no dysplasia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Clinicopathological review optimises management and triage of patients with pHSIL on referral cytology. Understanding outcomes in these patients informs counselling and management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13348","type":"journal-article","created":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T17:09:11Z","timestamp":1620061751000},"page":"569-575","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Possible high\u2010grade squamous intraepithelial lesion (pHSIL) in the new cervical screening paradigm: The outcomes and the role of clinicopathological review"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2556-0755","authenticated-orcid":false,"given":"Monica Francesca Giannini","family":"McGauran","sequence":"first","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology The Mercy Hospital for Women Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam Bernard","family":"Pendlebury","sequence":"additional","affiliation":[{"name":"Department of Gynaecological Oncology The Mercy Hospital for Women Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard John","family":"Hiscock","sequence":"additional","affiliation":[{"name":"Translational Obstetrics Group Department of Obstetrics &amp; Gynaecology The Mercy Hospital for Women, University of Melbourne Melbourne Victoria Australia"},{"name":"Mercy Perinatal The Mercy Hospital for Women Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie M.","family":"Lamont","sequence":"additional","affiliation":[{"name":"Department of Gynaecological Oncology The Mercy Hospital for Women Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonia P.M.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Gynaecological Oncology The Mercy Hospital for Women Melbourne Victoria Australia"},{"name":"Department of Gynaecological Oncology The Royal Women\u2019s Hospital Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Grant","sequence":"additional","affiliation":[{"name":"Department of Gynaecological Oncology The Mercy Hospital for Women Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marsali Ruth","family":"Newman","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology Austin Health Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerryn","family":"Ireland\u2010Jenkin","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology Austin Health Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaun","family":"McGrath","sequence":"additional","affiliation":[{"name":"Department of Gynaecological Oncology The Mercy Hospital for Women Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim","family":"Pham","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology The Northern Hospital Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Hyde","sequence":"additional","affiliation":[{"name":"Department of Gynaecological Oncology The Mercy Hospital for Women Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,5,3]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"BuddA HammondI Cancer Council Australia Cervical Cancer Screening Guidelines Working Party. [Version URL:https:\/\/wiki.cancer.org.au\/australiawiki\/index.php?oldid=190188. Cited 24 July 2020.]. Available from URL:https:\/\/wiki.cancer.org.au\/australia\/Guidelines:Cervical_cancer\/Screening\/Cervical_Cancer_in_Australia. In: Cancer Council Australia Cervical Cancer Screening Guidelines Working Party.National Cervical Screening Program: Guidelines for the management of screen\u2010detected abnormalities screening in specific populations and investigation of abnormal vaginal bleeding.Sydney:Cancer Council Australia. Available from URL:https:\/\/wiki.cancer.org.au\/australia\/Guidelines:Cervical_cancer\/Screening"},{"key":"e_1_2_6_3_1","unstructured":"Australian Institute of Health and Welfare 2018.Cervical screening in Australia 2018. Cat. no. CAN 111.Canberra:AIHW. 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Available from URL:https:\/\/wiki.cancer.org.au\/australia\/Guidelines:Cervical_cancer\/Screening"},{"key":"e_1_2_6_5_1","unstructured":"AndersonL SavilleM WrightG Cancer Council Australia Cervical Cancer Screening Guidelines Working Party. [Version URL:https:\/\/wiki.cancer.org.au\/australiawiki\/index.php?oldid=190192 cited 2020 Jul 24]. Available from URL: \">https:\/\/wiki.cancer.org.au\/australia\/Guidelines:Cervical_cancer\/Screening\/Cytology_and_AMBS_2004_terminology_for_reporting. In: Cancer Council Australia Cervical Cancer Screening Guidelines Working Party.National Cervical Screening Program: Guidelines for the management of screen\u2010detected abnormalities screening in specific populations and investigation of abnormal vaginal bleeding.Sydney:Cancer Council Australia. 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Available from URL:https:\/\/wiki.cancer.org.au\/australia\/Clinical_question:Normal_colposcopic_findings_following_LBC_prediction_of_LSIL_or_HSIL. In: Cancer Council Australia Cervical Cancer Screening Guidelines Working Party. National Cervical Screening Program: Guidelines for the management of screen\u2010detected abnormalities screening in specific populations and investigation of abnormal vaginal bleeding.Sydney:Cancer Council Australia. Available from:https:\/\/wiki.cancer.org.au\/australia\/Guidelines:Cervical_cancer\/Screening"},{"key":"e_1_2_6_19_1","first-page":"CD008478","article-title":"Fertility and early pregnancy outcomes after conservative treatment for cervical intraepithelial neoplasia","volume":"9","author":"Kyrgiou M","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"issue":"11","key":"e_1_2_6_20_1","first-page":"CD012847","article-title":"Obstetric outcomes after conservative treatment for cervical intraepithelial lesions and early invasive disease","author":"Kyrgiou M","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.32050"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0025493"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0b013e3182854282"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30032"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21388"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.13136"}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13348","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ajo.13348","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13348","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T16:11:07Z","timestamp":1693325467000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.13348"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,3]]},"references-count":25,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1111\/ajo.13348"],"URL":"https:\/\/doi.org\/10.1111\/ajo.13348","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"type":"print","value":"0004-8666"},{"type":"electronic","value":"1479-828X"}],"subject":[],"published":{"date-parts":[[2021,5,3]]},"assertion":[{"value":"2020-12-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}