Dual stain reduces unnecessary colposcopy referral
and unnecessary cervical biopsies, and may reduce unnecessary treatment compared with Papanicolaou cytologic testing," Dr.
Moreover, the lack of cytological abnormalities in most of them increases unnecessary colposcopy referral
and psychological distress of those patients.
Routine cervical smear taking and STI screening are a large part of RNs' daily work, which includes colposcopy referral
and treatment of infections.
Initial clinical assessments of a colposcopy referral
population showed that the test had better than anticipated specificity with equivalent sensitivity, versus traditional NAAT methods, including equivalent numbers of true positives and notably fewer false positives in women with negative biopsies, noted Dr.
2008 NTCC Pathology Group, The risk of false-positive histology according to the reason for colposcopy referral
in cervical cancer screening: a blind revision of all histologic lesions found in the NTCC trial, American Journal of Clinical Pathology, 129(1): 75-80.
(4) However, referrals of low-grade dysplasia to GSH probably represent a small fraction of the true number of women requiring colposcopy, given the low Pap smear rates reported at PHC sites, and the requirement of two low-grade Pap smear abnormalities for colposcopy referral
. As cervical screening increases, the number of cases of low-grade cervical disease requiring follow-up is likely to outpace growth in colposcopy services.
Those patients with less than HSIL, however, should undergo a repeat Pap in another 12 months, at which point, evidence of ASC-US or greater warrants a colposcopy referral
, he said.
The 2001 guidelines recommended a course of intravaginal estrogen followed by repeat cervical cytology for postmenopausal women, and colposcopy referral
for all immunosuppressed women.
Secondary endpoints included the 48-month rate of CIN2+, the threshold for colposcopy referral
, and the effect of primary HPV testing on colposcopy.
Colposcopy results were not collected at the time of the study, as its initial focus was to investigate the most recent incidence of colposcopy referrals
(which would indicate a high risk of invasive lesions).
(11) Although this higher specificity could potentially help reduce colposcopy referrals
, widespread adoption of E6E7 mRNA tests will likely be limited by the test's complexity and need for expensive laboratory instruments.
The authors noted that the large number of false-positive HPV results--and the associated colposcopy referrals
, risks of overtreatment and costs--were a major limitation of the study.