{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T20:27:08Z","timestamp":1754598428202,"version":"3.40.5"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,9,10]],"date-time":"2021-09-10T00:00:00Z","timestamp":1631232000000},"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>Background<\/jats:title><jats:p>The renewed National Cervical Screening Program incorporating primary human papillomavirus (HPV) screening was implemented in Australia in December 2017. In a previous study conducted in the UK, primary HPV screening was found to be associated with a 25% reduction in the incidence of negative histology following loop electrosurgery excision procedure (LEEP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To examine the change in incidence and associated risk factors for a negative LEEP with introduction of primary HPV screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A retrospective review of the records of all patients undergoing a LEEP excision for biopsy\u2010proven high\u2010grade cervical intra\u2010epithelial lesions between 1 January 2014 and 30 June 2019 in a specialised centre.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 1123 patients who underwent a LEEP included in the analysis. The incidence of a negative LEEP specimen was 7.5% (59\/784) and 5.3% (18\/339) in the pre\u2010 and post\u2010HPV screening cohort. More patients in the post\u2010HPV screening group had low\u2010grade cytology on referral (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), smaller cervical lesions on colposcopy (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.012) and longer biopsy to treatment interval (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.020). Primary HPV screening was associated with a significant reduction in the incidence of a negative LEEP specimen in a propensity matched cohort (11.2% to 5.1%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.006) and a 41% (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.045) decreased relative risk of a negative LEEP on multivariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Primary HPV screening results in a lower incidence of negative LEEP histology, despite a longer biopsy to treatment wait time and higher proportion of low\u2010grade cytology at triage.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13426","type":"journal-article","created":{"date-parts":[[2021,9,10]],"date-time":"2021-09-10T12:54:11Z","timestamp":1631278451000},"page":"941-948","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The impact of primary human papillomavirus screening on negative loop excision histology following biopsy\u2010proven high\u2010grade cervical intra\u2010epithelial lesions: A review from a large tertiary colposcopy unit"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9018-5974","authenticated-orcid":false,"given":"Huan","family":"Xie","sequence":"first","affiliation":[{"name":"Lifehouse Gynaecological Oncology Group Chris O\u2019Brien Lifehouse Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8586-2392","authenticated-orcid":false,"given":"Rhett","family":"Morton","sequence":"additional","affiliation":[{"name":"Lifehouse Gynaecological Oncology Group Chris O\u2019Brien Lifehouse Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5819-8839","authenticated-orcid":false,"given":"Jananie","family":"Balendran","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Royal Prince Alfred Hospital Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1588-0747","authenticated-orcid":false,"given":"Shannon","family":"Philp","sequence":"additional","affiliation":[{"name":"Lifehouse Gynaecological Oncology Group Chris O\u2019Brien Lifehouse Susan Wakil School of Nursing Sydney Nursing School The University of Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5165-2461","authenticated-orcid":false,"given":"Samir","family":"Saidi","sequence":"additional","affiliation":[{"name":"Lifehouse Gynaecological Oncology Group Chris O\u2019Brien Lifehouse Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7036-8968","authenticated-orcid":false,"given":"Rhonda","family":"Farrell","sequence":"additional","affiliation":[{"name":"Lifehouse Gynaecological Oncology Group Chris O\u2019Brien Lifehouse Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9405-8195","authenticated-orcid":false,"given":"Lyndal","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Tissue Pathology and Diagnostic Oncology Royal Prince Alfred Hospital Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1130-4275","authenticated-orcid":false,"given":"Selvan","family":"Pather","sequence":"additional","affiliation":[{"name":"Lifehouse Gynaecological Oncology Group Chris O\u2019Brien Lifehouse Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,9,10]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"NCSP.National cervical screening program: guidelines for the management of screen detected abnormalities screening in specific populations and investigation of abnormal vaginal bleeding(2017). [https:\/\/wiki.cancer.org.au\/australia\/Guidelines:Cervical_cancer\/Screening]. [updated Jan 2021]."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(11)70145-0"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(11)70296-0"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(09)70360-2"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30926"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1997.tb10658.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2000.tb11103.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000132803.88049.84"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000061"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2014.11.009"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2016.03.032"},{"key":"e_1_2_6_13_1","unstructured":"The Royal College of Pathologists of Australia.Framework for the development of structured cancer pathology reporting protocols[Available from:https:\/\/www.rcpa.edu.au\/getattachment\/9ed056b7\u20106bcc\u20104885\u2010a243\u2010925053302e3b\/Protocol\u2010Cervical\u2010pre\u2010neoplasia.aspx]. [updated March 2017]."},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/70.1.41"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2012.10.020"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.LGT200570"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/PGP.0000000000000152"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-04-2599"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000189"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000410"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.17061\/phrp2921914"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.02.029"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0756.2010.01427.x"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000260"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.13248"}],"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.13426","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ajo.13426","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13426","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T12:37:17Z","timestamp":1693226237000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.13426"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,10]]},"references-count":24,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1111\/ajo.13426"],"URL":"https:\/\/doi.org\/10.1111\/ajo.13426","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"type":"print","value":"0004-8666"},{"type":"electronic","value":"1479-828X"}],"subject":[],"published":{"date-parts":[[2021,9,10]]},"assertion":[{"value":"2021-01-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}