Effectiveness of see-and-treat for approaching pre-invasive lesions of uterine cervix
Autor(a) principal: | |
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Data de Publicação: | 2009 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102009000500014 |
Resumo: | OBJECTIVE: To compare the effectiveness between the see-and-treat (S&T) approach and the conventional one (with prior biopsy) for squamous intraepithelial lesions of uterine cervix. METHODS: A cross-sectional study was conducted with 900 nonpregnant women with cytology suggestive of high grade squamous intraepithelial lesions in the city of Rio de Janeiro, Southeastern Brazil, between 1998 and 2004. The S&T approach consists of a large loop excision of the transformation zone procedure and is recommended when cytology is suggestive of high grade squamous intraepithelial lesion, satisfactory colposcopy with abnormalities compatible with the suspected cytological results, and the lesion is limited to the ectocervix or extends up to one centimeter of the endocervical canal. A subgroup of 336 patients whose colposcopy was considered satisfactory was analyzed, and they were divided into two groups for comparison: patients treated without prior biopsy (n = 288) and patients treated after a biopsy showing high grade squamous intraepithelial lesions (n = 48). Patients who were not treated or only treated more than a year later after recruitment at the colposcopy unit were considered dropouts. RESULTS: Of patients recruited during the study period, 71 were not treated or were only treated for at least a year. The overall dropout rate was 7.9% (95% CI: 6.1;9.7). Mean time elapsed between patient recruitment and treatment was 17.5 days in the S&T group and 102.5 days in the prior biopsy group. Dropout rates were 1.4% (95% CI: 0.04;2.7) and 5.% (95% CI: 0;12.3), respectively (p=0.07). The proportion of overtreated cases (negative histology) in the S&T group was 2.0% (95% CI: 0.4;3.6). CONCLUSIONS: The difference in the mean time elapsed between patient recruitment and treatment indicates that S&T is a time-saving approach The proportion of negative cases from using the S&T approach can be regarded as low. |
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Revista de Saúde Pública |
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Effectiveness of see-and-treat for approaching pre-invasive lesions of uterine cervixCervix UteripathologyColposcopyclassificationCervical Intraepithelial NeoplasiaUterine Cervical NeoplasmsdiagnosisOBJECTIVE: To compare the effectiveness between the see-and-treat (S&T) approach and the conventional one (with prior biopsy) for squamous intraepithelial lesions of uterine cervix. METHODS: A cross-sectional study was conducted with 900 nonpregnant women with cytology suggestive of high grade squamous intraepithelial lesions in the city of Rio de Janeiro, Southeastern Brazil, between 1998 and 2004. The S&T approach consists of a large loop excision of the transformation zone procedure and is recommended when cytology is suggestive of high grade squamous intraepithelial lesion, satisfactory colposcopy with abnormalities compatible with the suspected cytological results, and the lesion is limited to the ectocervix or extends up to one centimeter of the endocervical canal. A subgroup of 336 patients whose colposcopy was considered satisfactory was analyzed, and they were divided into two groups for comparison: patients treated without prior biopsy (n = 288) and patients treated after a biopsy showing high grade squamous intraepithelial lesions (n = 48). Patients who were not treated or only treated more than a year later after recruitment at the colposcopy unit were considered dropouts. RESULTS: Of patients recruited during the study period, 71 were not treated or were only treated for at least a year. The overall dropout rate was 7.9% (95% CI: 6.1;9.7). Mean time elapsed between patient recruitment and treatment was 17.5 days in the S&T group and 102.5 days in the prior biopsy group. Dropout rates were 1.4% (95% CI: 0.04;2.7) and 5.% (95% CI: 0;12.3), respectively (p=0.07). The proportion of overtreated cases (negative histology) in the S&T group was 2.0% (95% CI: 0.4;3.6). CONCLUSIONS: The difference in the mean time elapsed between patient recruitment and treatment indicates that S&T is a time-saving approach The proportion of negative cases from using the S&T approach can be regarded as low.Faculdade de Saúde Pública da Universidade de São Paulo2009-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102009000500014Revista de Saúde Pública v.43 n.5 2009reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USP10.1590/S0034-89102009000500014info:eu-repo/semantics/openAccessMonteiro,Aparecida Cristina SampaioRussomano,FábioReis,AldoCamargo,Maria José deFialho,Susana AidéTristão,Maria AparecidaSoares,Thierseng2009-10-20T00:00:00Zoai:scielo:S0034-89102009000500014Revistahttp://www.scielo.br/scielo.php?script=sci_serial&pid=0034-8910&lng=pt&nrm=isoONGhttps://old.scielo.br/oai/scielo-oai.phprevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2009-10-20T00:00Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Effectiveness of see-and-treat for approaching pre-invasive lesions of uterine cervix |
title |
Effectiveness of see-and-treat for approaching pre-invasive lesions of uterine cervix |
spellingShingle |
Effectiveness of see-and-treat for approaching pre-invasive lesions of uterine cervix Monteiro,Aparecida Cristina Sampaio Cervix Uteri pathology Colposcopy classification Cervical Intraepithelial Neoplasia Uterine Cervical Neoplasms diagnosis |
title_short |
Effectiveness of see-and-treat for approaching pre-invasive lesions of uterine cervix |
title_full |
Effectiveness of see-and-treat for approaching pre-invasive lesions of uterine cervix |
title_fullStr |
Effectiveness of see-and-treat for approaching pre-invasive lesions of uterine cervix |
title_full_unstemmed |
Effectiveness of see-and-treat for approaching pre-invasive lesions of uterine cervix |
title_sort |
Effectiveness of see-and-treat for approaching pre-invasive lesions of uterine cervix |
author |
Monteiro,Aparecida Cristina Sampaio |
author_facet |
Monteiro,Aparecida Cristina Sampaio Russomano,Fábio Reis,Aldo Camargo,Maria José de Fialho,Susana Aidé Tristão,Maria Aparecida Soares,Thiers |
author_role |
author |
author2 |
Russomano,Fábio Reis,Aldo Camargo,Maria José de Fialho,Susana Aidé Tristão,Maria Aparecida Soares,Thiers |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Monteiro,Aparecida Cristina Sampaio Russomano,Fábio Reis,Aldo Camargo,Maria José de Fialho,Susana Aidé Tristão,Maria Aparecida Soares,Thiers |
dc.subject.por.fl_str_mv |
Cervix Uteri pathology Colposcopy classification Cervical Intraepithelial Neoplasia Uterine Cervical Neoplasms diagnosis |
topic |
Cervix Uteri pathology Colposcopy classification Cervical Intraepithelial Neoplasia Uterine Cervical Neoplasms diagnosis |
description |
OBJECTIVE: To compare the effectiveness between the see-and-treat (S&T) approach and the conventional one (with prior biopsy) for squamous intraepithelial lesions of uterine cervix. METHODS: A cross-sectional study was conducted with 900 nonpregnant women with cytology suggestive of high grade squamous intraepithelial lesions in the city of Rio de Janeiro, Southeastern Brazil, between 1998 and 2004. The S&T approach consists of a large loop excision of the transformation zone procedure and is recommended when cytology is suggestive of high grade squamous intraepithelial lesion, satisfactory colposcopy with abnormalities compatible with the suspected cytological results, and the lesion is limited to the ectocervix or extends up to one centimeter of the endocervical canal. A subgroup of 336 patients whose colposcopy was considered satisfactory was analyzed, and they were divided into two groups for comparison: patients treated without prior biopsy (n = 288) and patients treated after a biopsy showing high grade squamous intraepithelial lesions (n = 48). Patients who were not treated or only treated more than a year later after recruitment at the colposcopy unit were considered dropouts. RESULTS: Of patients recruited during the study period, 71 were not treated or were only treated for at least a year. The overall dropout rate was 7.9% (95% CI: 6.1;9.7). Mean time elapsed between patient recruitment and treatment was 17.5 days in the S&T group and 102.5 days in the prior biopsy group. Dropout rates were 1.4% (95% CI: 0.04;2.7) and 5.% (95% CI: 0;12.3), respectively (p=0.07). The proportion of overtreated cases (negative histology) in the S&T group was 2.0% (95% CI: 0.4;3.6). CONCLUSIONS: The difference in the mean time elapsed between patient recruitment and treatment indicates that S&T is a time-saving approach The proportion of negative cases from using the S&T approach can be regarded as low. |
publishDate |
2009 |
dc.date.none.fl_str_mv |
2009-10-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102009000500014 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102009000500014 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S0034-89102009000500014 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Faculdade de Saúde Pública da Universidade de São Paulo |
publisher.none.fl_str_mv |
Faculdade de Saúde Pública da Universidade de São Paulo |
dc.source.none.fl_str_mv |
Revista de Saúde Pública v.43 n.5 2009 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1748936498224300032 |