{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T09:25:56Z","timestamp":1781774756106,"version":"3.54.5"},"reference-count":11,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,5,4]],"date-time":"2023-05-04T00:00:00Z","timestamp":1683158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>To examine outcomes in women aged 50\u201374\u2009years after detection of oncogenic human papillomavirus (HPV) at cervical screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>A retrospective observational study of 464 women seen in the Royal Women's Hospital Colposcopy Clinic from 1 January 2018 to 31 July 2020, 292 (62.9%) were positive for HPV16\/18 and 172 (37.1%) for HPV (not 16\/18).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010four women (11.6%) had histologically proven CIN2+ including seven cancers, up to two\u2009years after first colposcopy visit (FCV): 48 (88.9%) detected at FCV or at excisional treatment (Excision) arranged after no CIN2+ detected at FCV. There was no significant difference (<jats:italic>P<\/jats:italic>\u2009=\u20090.14) in proportion of CIN2+ detected between the two groups, \u2018HPV16\/18\u2019 (9.9%) or \u2018HPV (not 16\/18)\u2019 (14.5%), nor with reflex cytology types. The positive predictive value (PPV) of high\u2010grade impression at colposcopy was 63.6%. There were 243 (52.4%) who had Type 3 transformation zone (TZ3) with 20 CIN2+ detected, 13 at FCV including all three cancers and five at Excision. There were 214 (73.3%) with positive HPV16\/18 who had reflex negative cytology, of which seven had CIN2+ including one cancer but only two (1.4%) CIN2+ when their repeat cytology at colposcopy was negative.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Most CIN2+ were detected at first colposcopy or at subsequent excision. We would encourage high biopsy rates at colposcopy and vigilance in selection for excisional treatment in TZ3 cases if there is no significant suspicion of high\u2010grade abnormality. There is a need to refine the algorithm for management of persistent HPV16\/18 infections with reflex negative cytology to reduce colposcopy referrals in women aged 50 and above.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13684","type":"journal-article","created":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T04:44:50Z","timestamp":1683261890000},"page":"564-570","source":"Crossref","is-referenced-by-count":2,"title":["Diagnostic outcomes after colposcopy at a tertiary clinic for women aged 50\u201374 referred after detection of oncogenic human papillomavirus at primary screening"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0226-8647","authenticated-orcid":false,"given":"Jeffery H. J.","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Oncology and Dysplasia The Royal Women's Hospital  Melbourne Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Oncology and Dysplasia The Royal Women's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Steele","sequence":"additional","affiliation":[{"name":"Department of Oncology and Dysplasia The Royal Women's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estefania","family":"Vicario","sequence":"additional","affiliation":[{"name":"Department of Oncology and Dysplasia The Royal Women's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. David H.","family":"Wrede","sequence":"additional","affiliation":[{"name":"Department of Oncology and Dysplasia The Royal Women's Hospital  Melbourne Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,4]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"National Cervical Screening Program: Guidelines for the Management of Screen\u2010Detected Abnormalities, Screening in Specific Populations and Investigation of Abnormal Vaginal Bleeding","author":"Cancer Council Australia Cervical Cancer Screening Guidelines Working Party","year":"2016"},{"key":"e_1_2_7_3_1","unstructured":"Cancer Australia.National Cancer Control Indicators. HPV Vaccination Uptake.2019. [Accessed 9 Jan 2022] Available from URL:https:\/\/ncci.canceraustralia.gov.au\/prevention\/hpv\u2010vaccination\u2010uptake\/hpv\u2010vaccination\u2010uptake."},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(09)70360-2"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(11)70296-0"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(11)70145-0"},{"key":"e_1_2_7_7_1","volume-title":"National Cervical Screening Program Monitoring Report 2021. Cancer Series No. 134. Cat. No. CAN 141","author":"Australian Institute of Health and Welfare","year":"2021"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.33128"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318254f90c"},{"key":"e_1_2_7_10_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2017"},{"key":"e_1_2_7_11_1","unstructured":"MedCalc for Windows Version 19.4 (MedCalc Software Ostend Belgium). [Accessed 9 January 2022] Available from URL:www.medcalc.org."},{"key":"e_1_2_7_12_1","unstructured":"National Monitoring of the Cervical Cancer Screening Programme in the Netherlands 2020. Publication date 10\/5\/2021. [Accessed 9 January 2022] Available from URL:https:\/\/www.rivm.nl\/sites\/default\/files\/2021\u201010\/IKNL_monitor%20BMHK.UK_.290921_def.pdf."}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13684","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T13:06:14Z","timestamp":1691586374000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.13684"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,4]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1111\/ajo.13684"],"URL":"https:\/\/doi.org\/10.1111\/ajo.13684","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"value":"0004-8666","type":"print"},{"value":"1479-828X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,4]]}}}