{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T06:10:08Z","timestamp":1713766208027},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2011,2,14]],"date-time":"2011-02-14T00:00:00Z","timestamp":1297641600000},"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":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2011,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p> <jats:italic>Objective.<\/jats:italic> Management of patients diagnosed on cervical smears with twice consecutively atypical squamous cells of undetermined significance (ASC\u2010US) remains a clinical dilemma. We describe a follow\u2010up of aggressive vs. less aggressive colposcopic treatment in order to determine which treatment is preferable. <jats:italic>Design.<\/jats:italic> Retrospective cohort study with a follow\u2010up of 10 years. <jats:italic>Setting.<\/jats:italic> Two hospitals in The Netherlands. <jats:italic>Population.<\/jats:italic> Women referred for primary colposcopy with two consecutive ASC\u2010US smears (<jats:italic>n<\/jats:italic>=230) to either one of the two hospitals. <jats:italic>Methods.<\/jats:italic> In one hospital, patients underwent direct loop excision of all colposcopically detected abnormalities, even if not suspected for cervical intraepithelial neoplasia (CIN; aggressive strategy; <jats:italic>n<\/jats:italic>=118). In the other hospital, a less aggressive policy was followed when low\u2010grade CIN lesions were suspected at colposcopy (less aggressive strategy; <jats:italic>n<\/jats:italic>=112). <jats:italic>Main Outcome Measures.<\/jats:italic> The number of loop excisions, detection of CIN lesions and cytological follow\u2010up of both groups. <jats:italic>Results.<\/jats:italic> Less aggressive management resulted in less loop excisions (<jats:italic>p<\/jats:italic>&lt;0.001). At initial colposcopy, the aggressive group showed a 10\u2010fold incidence of histologically detected CIN lesions compared with the less aggressive group (1.8 vs. 19.5%). During 10 years of follow\u2010up, both groups showed the same percentages of CIN lesions (8.1 vs. 8.4%). Aggressive management resulted in faster normalization of cervical smears (<jats:italic>p<\/jats:italic>&lt;0.001). However, at final follow\u2010up, there was no statistical difference in the percentage of normalization of cervical smears between both groups. <jats:italic>Conclusions.<\/jats:italic> Aggressive and less aggressive colposcopic strategies are equally safe and show good clinical outcomes. Treatment decisions, however, must be adjusted to women's individual demands.<\/jats:p>","DOI":"10.1111\/j.1600-0412.2010.01062.x","type":"journal-article","created":{"date-parts":[[2011,1,3]],"date-time":"2011-01-03T11:40:36Z","timestamp":1294054836000},"page":"313-318","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["To treat or not to treat; the clinical dilemma of atypical squamous cells of undetermined significance (ASC\u2010US)"],"prefix":"10.1111","volume":"90","author":[{"given":"ROOSMARIE P.","family":"DE BIE","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"LEON F.A.G.","family":"MASSUGER","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ROEL A.J.M.","family":"VAN DONGEN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MARC P.M.L.","family":"SNIJDERS","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JOHAN","family":"BULTEN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"WILLEM J.G.","family":"MELCHERS","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"RUUD L.M.","family":"BEKKERS","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,2,14]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/93.4.293"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.20076"},{"key":"e_1_2_7_4_2","first-page":"1288","article-title":"Herziening bevolkingsonderzoek op baarmoederhalskanker 1996: hogere dekkingsgraad, minder herhalingsuitstrijkjes en minder opportunistische screening. 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