{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T14:29:14Z","timestamp":1792592954982,"version":"4.5.0"},"reference-count":19,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"11","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Glob Oncol"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n            <jats:title>PURPOSE<\/jats:title>\n            <jats:p>In Botswana, a see-and-treat approach to cervical cancer screening is taken. Our objective was to determine the number of loop electrosurgical excision procedures (LEEPs) performed for cervical intraepithelial neoplasia (CIN) 2\/3 in Botswana, and follow-up rates and outcomes, among women with positive cervical margins.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS<\/jats:title>\n            <jats:p>Data (patient age, HIV status, margin status, follow-up, and recurrence) from women who underwent LEEP with histologically confirmed CIN 2\/3 between January 2014 and December 2015 were analyzed retrospectively. Histopathologic reports were reviewed at a central laboratory in Gaborone, Botswana. Follow-up and recurrence rates were summarized descriptively and compared according to HIV and margin statuses using chi-squared tests.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>In total, 779 women (median age, 39.2 years) underwent LEEP showing CIN2\/3; 638 (81.9%) women had CIN3 and 390 (50.1%) had positive LEEP margins (ectocervical, 186 [47.7%]; endocervical [including with ectocervical], 204 [52.4%]). Margin positivity was not associated with HIV status. Of women with positive endocervical margins followed at \u22641 and &gt;1 year, 9.6% and 48.3%, respectively, had persistent CIN2\/3 on repeat LEEP. Forty percent (90 of 204) of women with positive endocervical margins had no re-excision documented.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION<\/jats:title>\n            <jats:p>Most women who underwent LEEP had CIN3 and positive margins. Almost half with positive margins followed at &gt;1 year after initial LEEP had CIN2\/3 recurrence warranting further treatment; two thirds were not followed. Resources are needed to improve post-LEEP follow-up for women with margin positivity who require additional ablative\/excisional procedures to reduce the cervical cancer burden in Botswana.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1200\/go-24-00472","type":"journal-article","created":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T21:08:53Z","timestamp":1742504933000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":2,"title":["Outcomes of Loop Electrosurgical Excision Procedures Performed for Severe Cervical Dysplasia in Botswana"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6170-1084","authenticated-orcid":true,"given":"Lisa","family":"Bazzett-Matabele","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University of Botswana, Gaborone, Botswana"},{"name":"Department of Obstetrics and Gynecology, Yale University, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manya","family":"Gupta","sequence":"additional","affiliation":[{"name":"College of Arts and Sciences, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8479-8512","authenticated-orcid":true,"given":"Emily","family":"MacDuffie","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0319-4272","authenticated-orcid":true,"given":"Jessica","family":"George","sequence":"additional","affiliation":[{"name":"University of California, Irvine, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Ball","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, South London and Maudsley NHS Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jemma","family":"Hazan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2161-3135","authenticated-orcid":true,"given":"Mohan","family":"Narasimhamurthy","sequence":"additional","affiliation":[{"name":"Department of Pathology, Vanderbilt University Medical Centre, Nashville, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Maoto-Mokote","sequence":"additional","affiliation":[{"name":"National Health Laboratory, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Seiphetlheng","sequence":"additional","affiliation":[{"name":"Department of Gynaecologic Oncology, Princess Marina Hospital, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barati","family":"Monare","sequence":"additional","affiliation":[{"name":"Department of Gynaecologic Oncology, Princess Marina Hospital, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1975-8837","authenticated-orcid":true,"given":"Rebecca","family":"Luckett","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9624-8366","authenticated-orcid":true,"given":"Doreen","family":"Ramogola-Masire","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University of Botswana, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surbhi","family":"Grover","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA"},{"name":"Botswana-UPenn Partnership, Philadelphia, PA and Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","unstructured":"Ferlay J Colombet M Soerjomataram I et al: Cancer statistics for the year 2020: An overview. 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