{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:36:44Z","timestamp":1747183004345,"version":"3.40.5"},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,7,19]],"date-time":"2021-07-19T00:00:00Z","timestamp":1626652800000},"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":[[2021,12]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To examine outcomes in women following cervical screening detection of oncogenic human papillomavirus (HPV), with reflex cytology showing possible high\u2010grade squamous intraepithelial lesion (pHSIL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>A retrospective observational study of 523 women seen in the Royal Women\u2019s Hospital Colposcopy Clinic from 1 January 2018 to 31 July 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred eighty\u2010two (53.9%) women had histology\u2010confirmed HSIL, encompassing CIN2 or worse (CIN2+), including seven cancers (1.3%) and two adenocarcinoma in situ (AIS) (0.4%). In 81.2% (229\/282) of women with CIN2+, this was detected on cervical biopsy at initial colposcopy, with another 8.9% (25\/282) of CIN2+ detected at cervical excision following initial colposcopy and the remaining 9.9% (28\/282) at follow\u2010up colposcopy thereafter. When discordant cervical biopsy results were discussed at multidisciplinary meeting (MDM), 66.7% of women with pHSIL cytology upgraded to definite HSIL were found to have CIN2+, but only 20.8% when pHSIL cytology was retained and none when downgraded to low\u2010grade (LSIL) or normal. No significant difference was found in the proportion of CIN2+ based on patient age above or below 40, HPV16 and\/or 18 versus non 16\/18, or whether discordant findings were reviewed at MDM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We propose a pathway for management of women with positive oncogenic HPV and reflex pHSIL cytology. MDM review is recommended when CIN2+ is not identified on cervical biopsy at initial colposcopy. Conservative management is safe with low risk of CIN2+ when LBC prediction of pHSIL is confirmed or downgraded at MDM with no high\u2010grade change on colposcopy or repeat cytology.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13408","type":"journal-article","created":{"date-parts":[[2021,7,19]],"date-time":"2021-07-19T15:14:48Z","timestamp":1626707688000},"page":"910-917","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of women with positive oncogenic HPV and reflex cytology showing possible high\u2010grade squamous intraepithelial lesion"],"prefix":"10.1111","volume":"61","author":[{"given":"Hamon Y.K.","family":"Ng","sequence":"first","affiliation":[{"name":"Department of Oncology &amp; Dysplasia The Royal Women\u2019s Hospital Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0226-8647","authenticated-orcid":false,"given":"Jeffrey H.J.","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Oncology &amp; Dysplasia The Royal Women\u2019s Hospital Parkville Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology University of Melbourne Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra H.","family":"Marceglia","sequence":"additional","affiliation":[{"name":"Department of Oncology &amp; Dysplasia The Royal Women\u2019s Hospital Parkville Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology University of Melbourne Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Bittinger","sequence":"additional","affiliation":[{"name":"Department of Pathology The Royal Women\u2019s Hospital Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristy E.","family":"Dundas","sequence":"additional","affiliation":[{"name":"VCS Pathology VCS Foundation Carlton Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen L.","family":"Talia","sequence":"additional","affiliation":[{"name":"Department of Pathology The Royal Women\u2019s Hospital Parkville Victoria Australia"},{"name":"VCS Pathology VCS Foundation Carlton Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. David H.","family":"Wrede","sequence":"additional","affiliation":[{"name":"Department of Oncology &amp; Dysplasia The Royal Women\u2019s Hospital Parkville Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology University of Melbourne Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,7,19]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"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(2017).https:\/\/wiki.cancer.org.au\/australia\/Guidelines:Cervical_cancer\/Screening(accessed 17 March 2021)."},{"key":"e_1_2_8_3_1","unstructured":"Victorian Cervical Cytology Registry.Statistical Report 2015. Published December 2017. ISSN 2202\u20104417."},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPYK60BZRNNAHQ"},{"key":"e_1_2_8_5_1","unstructured":"The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.Cervical Quality Improvement Program (C\u2010QuIP) RANZCOG Quality Assurance. 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