Factors Related to Overtreatment in the See-and-Treat Approach: A Retrospective Multicentric Observational Study

Andrea Ciavattini, Stefano Morini, Giovanni Delli Carpini, Anna Del Fabro, Matteo Serri, Valeria Verdecchia, Federica Cigolot, Manuela Cadel, Nicolò Clemente, Francesco Sopracordevole

Research output: Contribution to journalArticle

Abstract

Objective The aim of the study was to evaluate the association between colposcopic features, age, menopausal status, and overtreatment in women subjected to "see-and-treat" approach, to identify subgroups of patients in which this approach could be more appropriate. Materials and Methods Retrospective multicentric cohort study conducted on women older than 25 years, with a high-grade squamous cytological report and a visible squamocolumnar junction, in which colposcopy and the excisional procedure were performed at the same time without a previous cervical biopsy (see and treat). Overtreatment was defined as histopathological finding of cervical intraepithelial lesion grade 1 or normal tissue. Results Among the 254 included patients, the overall overtreatment rate was 12.6%, whereas in women with a grade 2 colposcopy, it was 3.2% and, in women with grade 1 colposcopy, it was 22.0%. Among the considered factors (age, menopause, and grade 1 colposcopy), only a positive association with overtreatment and grade 1 colposcopy emerged (odds ratio = 8.70, 95% CI = 2.95-25.62, p <.001). Conclusions See and treat may be appropriate in women older than 25 years with a visible squamocolumnar junction and a high-grade squamous cervical cytology. Patients need to be informed about the higher risk of overtreatment in case of a grade 1 colposcopic impression, which however may still be considered acceptable. Patient's age and menopausal status should not influence the decision to propose a see-and-treat approach.

Original languageEnglish
Pages (from-to)129-132
Number of pages4
JournalJournal of Lower Genital Tract Disease
Volume23
Issue number2
DOIs
Publication statusPublished - Apr 1 2019

Keywords

  • cervical cancer
  • cervical cytology
  • cervical excision
  • cervical intraepithelial neoplasia
  • colposcopy
  • see and treat

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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    Ciavattini, A., Morini, S., Delli Carpini, G., Del Fabro, A., Serri, M., Verdecchia, V., Cigolot, F., Cadel, M., Clemente, N., & Sopracordevole, F. (2019). Factors Related to Overtreatment in the See-and-Treat Approach: A Retrospective Multicentric Observational Study. Journal of Lower Genital Tract Disease, 23(2), 129-132. https://doi.org/10.1097/LGT.0000000000000455