{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T06:07:17Z","timestamp":1783836437449,"version":"3.55.0"},"reference-count":37,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100008628","name":"Institut for Klinisk Medicin, Aarhus Universitet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008628","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008363","name":"Kr\u00e6ftens Bek\u00e6mpelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008363","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007403","name":"Dagmar Marshalls Fond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007403","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005747","name":"A.P. M\u00f8ller og Hustru Chastine Mc-Kinney M\u00f8llers Fond til almene Formaal","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005747","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010727","name":"Axel Muusfeldts Fond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010727","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010347","name":"Fabrikant Einar Willumsens Mindelegat","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010347","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008262","name":"Harboefonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008262","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006088","name":"Direkt\u00f8r Emil C. Hertz og Hustru Inger Hertz Fond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006088","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006426","name":"Eva og Henry Fr\u00e6nkels Mindefond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006426","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>To evaluate the diagnostic performance of systematic multiple biopsies in individuals with a transformation zone type 3 (TZ3) at colposcopy and to assess the influence of referral status and the use of dynamic spectral imaging (DSI) colposcopy on the detection of CIN2+ lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>In this multicentre cross\u2010sectional study, a total of 189 individuals referred with abnormal cytology and\/or hrHPV positivity with a TZ3 at colposcopy were included at three colposcopy clinics in the Central Denmark Region. Data were obtained from questionnaires, electronic medical records and the Danish National Pathology Registry. All participants underwent colposcopy with four cervical biopsies. Histological outcomes were based on the combined results of all four biopsies and, when available, compared with the corresponding large loop excision of the transformation zone (LLETZ) specimens. One centre employed DSI colposcopy, while two centres used conventional colposcopy. Main outcome measures were CIN2+ detection rate and sensitivity of individual and combined biopsies, assessed overall and stratified by referral status and colposcopy method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The overall CIN2+ detection rate was 16.9%. The detection rate increased with each additional biopsy, with the highest sensitivity observed at the fourth biopsy (71.4%). The detection rate was significantly higher among individuals referred with high\u2010grade abnormalities (42.6%) compared with low\u2010grade referrals (6.4%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The use of DSI colposcope did not significantly improve biopsy sensitivity. Concordance between biopsy and LLETZ histology was 85.3%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Systematic multiple biopsies improve CIN2+ detection in women with TZ3 but may lead to overtreatment in those referred with low\u2010grade abnormalities. Despite this approach, the true CIN2+ detection rate may still be underestimated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.70243","type":"journal-article","created":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T05:35:14Z","timestamp":1778909714000},"page":"1597-1606","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing the clinical value of cervical biopsies in individuals with transformation zone type 3 at colposcopy: A cross\u2010sectional study"],"prefix":"10.1111","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3663-9431","authenticated-orcid":false,"given":"Vibe Munk","family":"Bertelsen","sequence":"first","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Aarhus University Hospital and University Research Clinic for Cancer Screening Department of Public Health Programmes, Central Denmark Region  Randers Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9134-804X","authenticated-orcid":false,"given":"Berit Bargum","family":"Booth","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Randers Regional Hospital and Department of Gynaecology and Obstetrics Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mette","family":"Tranberg","sequence":"additional","affiliation":[{"name":"University Research Clinic for Cancer Screening, Department of Public Health Programmes, and Department of Clinical Medicine Aarhus University  Randers Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lone Kjeld","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pinar","family":"Bor","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Aarhus University Hospital and Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60022-7"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.55.9948"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000838"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-022-10030-7"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/08941939.2020.1850944"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-024-12156-2"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16250"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.09.039"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.issn.0529-567x.2019.06.007"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13462"},{"issue":"6","key":"e_1_2_14_12_1","first-page":"877","article-title":"After\u2010effects reported by women following colposcopy, cervical biopsies and LLETZ: results from the TOMBOLA trial","volume":"116","author":"TOMBOLA (Trial Of Management of Borderline and Other Low\u2010grade Abnormal smears) Group","year":"2009","journal-title":"BJOG"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17299"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol30060431"},{"key":"e_1_2_14_15_1","unstructured":"DSOG.Danish National Guideline for cervical dysplasia.2022."},{"key":"e_1_2_14_16_1","unstructured":"Swedish National Guideline: Nationellt\u2010vardprogram\u2010cervixcancerprevention.2022."},{"key":"e_1_2_14_17_1","unstructured":"EnglandN.Cervical screening: programme and colposcopy management. Guidelines for commissioners screening providers and programme managers for NHS cervical screening.GOV.UK: NHS England;2024."},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17200"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16101816"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-021-01539-y"},{"issue":"6","key":"e_1_2_14_21_1","first-page":"877","article-title":"Endocervical sampling in women with suspected cervical neoplasia: A systematic review and meta\u2010analysis of diagnostic test accuracy studies","volume":"116","author":"Mathias D","year":"2022","journal-title":"BJOG"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/17434440.2022.2104638"},{"issue":"4","key":"e_1_2_14_23_1","first-page":"17","article-title":"Rate of detecting CIN3+ among patients with ASC\u2010US using digital colposcopy and dynamic spectral imaging","volume":"20","author":"Harris KE","year":"2020","journal-title":"Oncol Lett"},{"key":"e_1_2_14_24_1","unstructured":"Danish Health Authority.Cervical Cancer Screening. 2021."},{"key":"e_1_2_14_25_1","unstructured":"2011 IFCPC Nomenclature.2011 colposcopic terminology of the International Federation for Cervical Pathology and Colposcopy."},{"key":"e_1_2_14_26_1","unstructured":"Board WCoTE.Female genital Tumours: WHO classification of Tumours (medicine)5th Edition2020."},{"key":"e_1_2_14_27_1","unstructured":"Patobank \u2013 A nationwide data bank from pathoanatomical studies.2019www.patobank.dk"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-023-07281-5"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.06.048"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000270154.69879.09"},{"key":"e_1_2_14_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002330"},{"key":"e_1_2_14_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2008.09.007"},{"key":"e_1_2_14_35_1","article-title":"Surgery for cervical intraepithelial neoplasia","volume":"6","author":"Martin\u2010Hirsch PP","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_14_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2025.03.017"},{"key":"e_1_2_14_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.10.042"},{"key":"e_1_2_14_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17248"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.70243","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.70243","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.70243","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T05:17:43Z","timestamp":1783833463000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.70243"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,15]]},"references-count":37,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/aogs.70243"],"URL":"https:\/\/doi.org\/10.1111\/aogs.70243","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,15]]},"assertion":[{"value":"2025-11-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}