{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T10:12:33Z","timestamp":1760609553679,"version":"build-2065373602"},"reference-count":14,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:00:00Z","timestamp":1709251200000},"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":[[2024,8]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>To assess colposcopic performance and determine indicators for competency within the new Australian primary human papillomavirus (HPV) cervical screening program.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>A retrospective observational study of 4542 women seen at The Royal Women's Hospital Colposcopy Clinic in Melbourne, from 1 December 2017 to 31 July 2020 after a higher\u2010risk cervical screening test (CST) result.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Histological CIN2+ was detected in 25.1% up to two years from first colposcopy visit (FCV). The majority (86.7%) of CIN2+ was detected early within the first six\u2009months of presentation. Biopsy rate overall was 96.1% with abnormal colposcopic impression. Of four colposcopists with a lower biopsy rate, only one was able to achieve this early detection rate. Biopsy was also taken in over 30% of cases with negative reflex cytology and normal colposcopy, with CIN2+ detected in 5.0% among positive HPV16\/18 and 3.8% with non\u201016\/18 HPV. Positive predictive value of high\u2010grade colposcopic impression at FCV averaged 66.4% (range: 54.9\u201381.6% among our colposcopists) and is poorly correlated with early detection rate of CIN2+. Overall accuracy of colposcopy is 84.5% (range: 78.7\u201390.3%), buoyed by high true negative colposcopic predictions secondary to high rates of negative reflex cytology referral with the new screening algorithm and is also unlikely to be a useful colposcopy indicator.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Early detection rate of CIN2+ within the first six months of presentation is a useful measure of colposcopy competency and we would encourage our National Cancer Screening Register to explore this with the participating colposcopists.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13807","type":"journal-article","created":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T03:24:15Z","timestamp":1709263455000},"page":"375-382","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Colposcopy performance in the new primary <scp>HPV<\/scp> screening in Australia: How to determine colposcopy competency?"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0226-8647","authenticated-orcid":false,"given":"Jeffrey H.J.","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Oncology &amp; Dysplasia The Royal Women's Hospital  Melbourne Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah","family":"Neesham","sequence":"additional","affiliation":[{"name":"Department of Oncology &amp; Dysplasia The Royal Women's Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca A.","family":"Szabo","sequence":"additional","affiliation":[{"name":"Department of Oncology &amp; Dysplasia The Royal Women's Hospital  Melbourne Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalia","family":"Khomko","sequence":"additional","affiliation":[{"name":"Department of Oncology &amp; Dysplasia The Royal Women's Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Desiree","family":"Yap","sequence":"additional","affiliation":[{"name":"Department of Oncology &amp; Dysplasia The Royal Women's Hospital  Melbourne 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's Hospital  Melbourne 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":[[2024,3]]},"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. [Accessed 15 June 2023.] Available from URL:https:\/\/wiki.cancer.org.au\/australia\/Guidelines:Cervical_cancer\/Screening"},{"key":"e_1_2_8_3_1","unstructured":"Cervical Screening: Programme and Colposcopy Management. NHS England 2010. Last updated 5 January 2023. [Accessed 15 June 2023.] Available from URL:https:\/\/www.gov.uk\/government\/publications\/cervical\u2010screening\u2010programme\u2010and\u2010colposcopy\u2010management"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000322"},{"key":"e_1_2_8_5_1","unstructured":"European Federation for colposcopy (EFC) Performance Standards. [Accessed 15 June 2023.] Available from URL:https:\/\/efcolposcopy.eu\/performance\u2010standards\/"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000338"},{"key":"e_1_2_8_7_1","unstructured":"BSCCP Accreditation in Colposcopy. [Accessed 15 June 2023.] Available from URL:https:\/\/www.bsccp.org.uk\/colposcopist\u2010training\u2010accreditation"},{"key":"e_1_2_8_8_1","unstructured":"The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.Cervical Quality Improvement Program (C\u2010QuIP) RANZCOG Quality Assurance. [Accessed 15 June 2023.] Available from URL:http:\/\/ranzcog.edu.au\/cquip"},{"key":"e_1_2_8_9_1","unstructured":"Australian Institute of Health and Welfare.National Cervical Screening Program Monitoring Report 2022. Catalogue number CAN 149 AIHW Australian Government 2022."},{"volume-title":"R: A Language and Environment for Statistical Computing","year":"2017","author":"R Core Team","key":"e_1_2_8_10_1"},{"key":"e_1_2_8_11_1","unstructured":"MedCalc for Windows Version 19.1.17. Ostend: MedCalc Software. 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