{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T06:53:29Z","timestamp":1791183209424,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Colposcopy is most commonly indicated for people with screen\u2010positive cervical screening tests. However, clinical reasons such as post\u2010coital bleeding (PCB) or an abnormal appearing cervix can also prompt referral. Aotearoa New Zealand (AoNZ) transitioned from a cytology\u2010based to an HPV\u2010based cervical screening programme in September 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To assess the incidence of high\u2010grade or malignant pathology in people seen in Capital &amp; Coast colposcopy clinic for clinical reasons and to evaluate the impact of HPV\u2010based primary screening on these referral patterns and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review was undertaken of individuals referred to Capital &amp; Coast colposcopy services for clinical indications. Two cohorts were analysed: Cohort 1 (June 2021\u2013June 2023), during cytology\u2010based screening and Cohort 2 (November 2023\u2013November 2025), following implementation of HPV\u2010based screening. Clinical outcomes were obtained from hospital databases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Referrals for clinical reasons decreased significantly following the introduction of HPV screening, from 494\/1699 (29%) in Cohort 1 to 252\/2809 (9%) in Cohort 2 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). High\u2010grade or malignant pathology was detected less frequently in Cohort 2 (0\/252 (0%) vs. 7\/494 (1.4%)), although this was not statistically significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.10).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Referrals to colposcopy for clinical reasons decreased substantially following the introduction of HPV\u2010based primary screening, with no high\u2010grade or malignant pathology detected among those referred in Cohort 2 who did not meet screening\u2010based referral criteria. While reassuring, HPV testing does not detect all cervical disease. Clinical assessment remains important for persistent or concerning symptoms or abnormal cervical findings, including consideration of HPV\u2010independent disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajo.70184","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T06:45:40Z","timestamp":1791182740000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Human Papillomavirus Primary Cervical Screening on Referral Rates and Outcomes for People Referred to Colposcopy for Clinical Reasons"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7825-4835","authenticated-orcid":false,"given":"Adibah","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Otago Wellington, Te Whatu Ora \u2013 Capital, Coast and Hutt Valley  Wellington New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5316-9117","authenticated-orcid":false,"given":"Katyana","family":"Gullery","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Otago Wellington, Te Whatu Ora \u2013 Capital, Coast and Hutt Valley  Wellington New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1749-6196","authenticated-orcid":false,"given":"Georgina","family":"Barber","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Otago Wellington, Te Whatu Ora \u2013 Capital, Coast and Hutt Valley  Wellington New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7162-6225","authenticated-orcid":false,"given":"Judy","family":"Ormandy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Otago Wellington, Te Whatu Ora \u2013 Capital, Coast and Hutt Valley  Wellington New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.ejogrb.2019.07.003","article-title":"The Diagnostic Accuracy of Colposcopy \u2013 A Review of Research Methodology and Impact on the Outcomes of Quality Assurance","volume":"240","author":"Brown B. H.","year":"2019","journal-title":"European Journal of Obstetrics & Gynecology and Reproductive Biology"},{"key":"e_1_2_9_3_1","volume-title":"Clinical Practice Guidelines for Cervical Screening in Aotearoa New Zealand","author":"Te Whatu Ora","year":"2023"},{"issue":"1","key":"e_1_2_9_4_1","first-page":"103","article-title":"The Frequency of Significant Pathology in Women Attending a General Gynaecological Service for Postcoital Bleeding","volume":"108","author":"Rosenthal A. N.","year":"2001","journal-title":"BJOG: An International Journal of Obstetrics and Gynaecology"},{"issue":"3","key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1111\/aogs.14121","article-title":"Benefits and Potential Harms of Human Papillomavirus (HPV)\u2010Based Cervical Cancer Screening: A Real\u2010World Comparison of HPV Testing Versus Cytology","volume":"100","author":"Thomsen L. T.","year":"2021","journal-title":"Acta Obstetricia et Gynecologica Scandinavica"},{"key":"e_1_2_9_6_1","volume-title":"Cervical Screening Numbers","author":"National Cervical Screening Programme","year":"2025"},{"key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/978-3-031-56806-0_34","volume-title":"Indigenous and Tribal Peoples and Cancer","author":"Lawton B.","year":"2024"},{"issue":"4","key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1097\/LGT.0000000000000338","article-title":"ASCCP Colposcopy Standards: Role of Colposcopy, Benefits, Potential Harms, and Terminology for Colposcopic Practice","volume":"21","author":"Khan M. J.","year":"2017","journal-title":"Journal of Lower Genital Tract Disease"},{"key":"e_1_2_9_9_1","volume-title":"Audit Summary","author":"Te Whatu Ora Capital, Coast and Hutt Valley","year":"2024"},{"issue":"1","key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1002\/ijc.34358","article-title":"Widening the Offer of Human Papillomavirus Self\u2010Sampling to All Women Eligible for Cervical Screening: Make Haste Slowly","volume":"153","author":"Rebolj M.","year":"2023","journal-title":"International Journal of Cancer"},{"issue":"20","key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"1908","DOI":"10.1056\/NEJMsr2030640","article-title":"The IARC Perspective on Cervical Cancer Screening","volume":"385","author":"Bouvard V.","year":"2021","journal-title":"New England Journal of Medicine"},{"issue":"11","key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1016\/j.jogc.2018.02.009","article-title":"Identifying Barriers to Treatment for Women With Cervical Dysplasia in Rural Northern British Columbia","volume":"40","author":"Jones M.","year":"2018","journal-title":"Journal of Obstetrics and Gynaecology Canada"},{"issue":"9","key":"e_1_2_9_13_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2025-099726","article-title":"Quantifying Unmet Secondary Healthcare Need in New Zealand: A Multi\u2010Year Population Study Using Administrative Data","volume":"15","author":"Bowden N.","year":"2025","journal-title":"BMJ Open"},{"issue":"1","key":"e_1_2_9_14_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0228042","article-title":"Implementation of Australia's Renewed Cervical Screening Program: Preparedness of General Practitioners and Nurses","volume":"15","author":"Sultana F.","year":"2020","journal-title":"PLoS One"},{"issue":"1","key":"e_1_2_9_15_1","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1001\/jama.2018.7464","article-title":"Effect of Screening With Primary Cervical HPV Testing vs Cytology Testing on High\u2010Grade Cervical Intraepithelial Neoplasia at 48 Months: The HPV FOCAL Randomized Clinical Trial","volume":"320","author":"Ogilvie G. S.","year":"2018","journal-title":"Journal of the American Medical Association"},{"issue":"1","key":"e_1_2_9_16_1","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1158\/1055-9965.EPI-20-1177","article-title":"Assessing 10\u2010Year Safety of a Single Negative HPV Test for Cervical Cancer Screening: Evidence From FOCAL\u2010DECADE Cohort","volume":"30","author":"Gottschlich A.","year":"2021","journal-title":"Cancer Epidemiology, Biomarkers & Prevention"},{"issue":"1","key":"e_1_2_9_17_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijgc.2024.100007","article-title":"Vulvar Inspection at the Time of Cervical Cancer Screening: European Society of Gynaecological Oncology (ESGO), International Society for the Study of Vulvovaginal Disease (ISSVD), European College for the Study of Vulval Disease (ECSVD), and European Federation for Colposcopy (EFC) Consensus Statements","volume":"35","author":"Preti M.","year":"2025","journal-title":"International Journal of Gynecological Cancer"},{"key":"e_1_2_9_18_1","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2020.606335","article-title":"Human Papillomavirus\u2010Negative Cervical Cancer: A Comprehensive Review","volume":"10","author":"Xing B.","year":"2020","journal-title":"Frontiers in Oncology"},{"issue":"6","key":"e_1_2_9_19_1","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1001\/jama.2023.13174","article-title":"Cervical Cancer Screening: A Review","volume":"330","author":"Perkins R. B.","year":"2023","journal-title":"Journal of the American Medical Association"},{"key":"e_1_2_9_20_1","volume-title":"Investigation of Intermenstrual and Postcoital Bleeding","author":"The Royal Australian and New Zealand College of Obstetricians and Gynaecologists","year":"2021"}],"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.70184","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ajo.70184","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.70184","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T06:45:44Z","timestamp":1791182744000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.70184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":19,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/ajo.70184"],"URL":"https:\/\/doi.org\/10.1111\/ajo.70184","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"value":"0004-8666","type":"print"},{"value":"1479-828X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-02-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70184"}}