RANZCOG Fellows’ adherence to guidelines following cytological prediction of cervical adenocarcinoma-in-situ: Cause for concern?
Background: For Australian women with screen-detected adenocarcinoma-in-situ (AIS), an excisional biopsy is mandatory for further assessment, treatment, and to exclude the presence of cervical adenocarcinoma. The only exclusion to this rule is if the woman has a clinically evident invasive cervical...
| Main Authors: | , , , , |
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| Format: | Journal Article |
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Blackwell Publishing
2018
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| Online Access: | http://hdl.handle.net/20.500.11937/73446 |
| _version_ | 1848763015439056896 |
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| author | Powell, A. Cohen, P. Spilsbury, Katrina Steel, N. Blomfield, P. |
| author_facet | Powell, A. Cohen, P. Spilsbury, Katrina Steel, N. Blomfield, P. |
| author_sort | Powell, A. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background: For Australian women with screen-detected adenocarcinoma-in-situ (AIS), an excisional biopsy is mandatory for further assessment, treatment, and to exclude the presence of cervical adenocarcinoma. The only exclusion to this rule is if the woman has a clinically evident invasive cervical malignancy. Excisional treatments should be tailored according to a patient's age and future obstetric needs. To date, practitioner compliance with this recommendation has not been investigated. Aims: To investigate clinical management for patients with a cytological test result predicting AIS. Secondary aims were to report the most severe histological findings of excisional biopsy specimens following cytological prediction of AIS and investigate treatment outcomes for conservatively managed patients with biopsy-confirmed AIS. Materials and Methods: A retrospective, population-based cohort study was conducted. Cases were ascertained from the Tasmanian and Western Australia Cervical Screening Registries. Cytology and histology results for women with an index cervical smear reporting AIS from 2001 to 2012 were reviewed. Results: Three hundred and twenty-one women (age range 18–69 years) had an index smear reporting AIS. Cervical cancer was diagnosed in 62 (19.3%) patients within the study cohort. Twenty-one of 321 patients (6.7%) were not initially managed according to the 2005 NHMRC Guidelines for the management of asymptomatic women with screen-detected abnormalities, including two women diagnosed with an occult cancer following a total hysterectomy. Conclusions: A minority of women were not managed in accordance with guidelines. This is of concern given that nearly one in five women with a smear predicting AIS had a final diagnosis of cervical cancer. |
| first_indexed | 2025-11-14T10:56:44Z |
| format | Journal Article |
| id | curtin-20.500.11937-73446 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T10:56:44Z |
| publishDate | 2018 |
| publisher | Blackwell Publishing |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-734462019-07-10T02:50:03Z RANZCOG Fellows’ adherence to guidelines following cytological prediction of cervical adenocarcinoma-in-situ: Cause for concern? Powell, A. Cohen, P. Spilsbury, Katrina Steel, N. Blomfield, P. Background: For Australian women with screen-detected adenocarcinoma-in-situ (AIS), an excisional biopsy is mandatory for further assessment, treatment, and to exclude the presence of cervical adenocarcinoma. The only exclusion to this rule is if the woman has a clinically evident invasive cervical malignancy. Excisional treatments should be tailored according to a patient's age and future obstetric needs. To date, practitioner compliance with this recommendation has not been investigated. Aims: To investigate clinical management for patients with a cytological test result predicting AIS. Secondary aims were to report the most severe histological findings of excisional biopsy specimens following cytological prediction of AIS and investigate treatment outcomes for conservatively managed patients with biopsy-confirmed AIS. Materials and Methods: A retrospective, population-based cohort study was conducted. Cases were ascertained from the Tasmanian and Western Australia Cervical Screening Registries. Cytology and histology results for women with an index cervical smear reporting AIS from 2001 to 2012 were reviewed. Results: Three hundred and twenty-one women (age range 18–69 years) had an index smear reporting AIS. Cervical cancer was diagnosed in 62 (19.3%) patients within the study cohort. Twenty-one of 321 patients (6.7%) were not initially managed according to the 2005 NHMRC Guidelines for the management of asymptomatic women with screen-detected abnormalities, including two women diagnosed with an occult cancer following a total hysterectomy. Conclusions: A minority of women were not managed in accordance with guidelines. This is of concern given that nearly one in five women with a smear predicting AIS had a final diagnosis of cervical cancer. 2018 Journal Article http://hdl.handle.net/20.500.11937/73446 10.1111/ajo.12886 Blackwell Publishing restricted |
| spellingShingle | Powell, A. Cohen, P. Spilsbury, Katrina Steel, N. Blomfield, P. RANZCOG Fellows’ adherence to guidelines following cytological prediction of cervical adenocarcinoma-in-situ: Cause for concern? |
| title | RANZCOG Fellows’ adherence to guidelines following cytological prediction of cervical adenocarcinoma-in-situ: Cause for concern? |
| title_full | RANZCOG Fellows’ adherence to guidelines following cytological prediction of cervical adenocarcinoma-in-situ: Cause for concern? |
| title_fullStr | RANZCOG Fellows’ adherence to guidelines following cytological prediction of cervical adenocarcinoma-in-situ: Cause for concern? |
| title_full_unstemmed | RANZCOG Fellows’ adherence to guidelines following cytological prediction of cervical adenocarcinoma-in-situ: Cause for concern? |
| title_short | RANZCOG Fellows’ adherence to guidelines following cytological prediction of cervical adenocarcinoma-in-situ: Cause for concern? |
| title_sort | ranzcog fellows’ adherence to guidelines following cytological prediction of cervical adenocarcinoma-in-situ: cause for concern? |
| url | http://hdl.handle.net/20.500.11937/73446 |