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Colposcopy

Colposcopy is a medical procedure used to visually inspect the cervix, vagina, and vulva for signs of disease.
This non-invasive technique employs a specialized microscope called a colposcope to magnify the area and identify any abnormal growths or lesions.
Colposcopy is commonly used as a follow-up to abnormal Pap smear results, helping clinicians diagnose and manage cervical cancer and other gynecological conditions.
By providing a detailed, magnified view of the affected area, colposcopy enhances the ability to accurately identify and monitor precancerous chages, enabling timely intervention and treatment.
This vital diagnostic tool plays a key role in cervical cancer screening and prevention effrots worldwide.

Most cited protocols related to «Colposcopy»

For the management guidelines, we chose CIN 3+ as the best surrogate for cancer risk. The definition of CIN 3+ as used in these guidelines includes CIN 3, AIS, and the rare cases of invasive cervical cancer that are found in screening programs. These management guidelines consider CIN 3+ risk at the time point relevant for the clinical action being considered—Clinical Action Thresholds for colposcopy and treatment consider immediate risks of CIN 3+, whereas longer-term surveillance recommendations use 5-year risks.
CIN3+ was chosen as an endpoint instead of cancer because cancer is uncommon in the United States, and risk is profoundly decreased by precursor treatment. Cancers that are found in robust screening programs may represent cancers already prevalent at first screening, rare instances of aggressive or HPV-negative tumors not detectable by screening, or false negative results.24 (link) CIN 3+ was chosen instead of CIN 2+ because it is a more pathologically reproducible diagnosis,25 (link) the HPV type distribution in CIN 3+ lesions more closely approximates that of invasive cervical cancers than the larger range of types found in CIN 2,15 (link)–18 (link),26 (link) and CIN 2 has appreciable regression rates in the absence of treatment.27 (link)–29 (link) The choice of CIN 3+ does have some limitations, as even among CIN 3/AIS lesions, risks of progression to cancer differ. Glandular lesions including AIS, lesions with HPV 16 and 18 infections, and those occurring in older patients have higher cancer risks than HPV-negative lesions and those occurring in younger patients.30 (link)Different nomenclatures for cervical histopathology are in use in the United States. The LAST Project and the WHO recommend a 2-tiered terminology (histologic LSIL/HSIL) for reporting histopathology of HPV-associated squamous lesions, similar to the Bethesda system used for reporting cervical cytology.31 (link),32 However, the CIN nomenclature is still commonly used, and data used to generate this set of guidelines relied on CIN nomenclature. Although no direct correlation is possible without use of the p16 biomarker, histologic HSIL is similar but not identical to CIN 2/3.33 (link)
Publication 2020
Biological Markers Cervical Cancer Cervical Intraepithelial Neoplasia, Grade III Colposcopy Cytological Techniques Diagnosis Disease Progression High-Grade Squamous Intraepithelial Lesions Human papillomavirus 16 Infection Low-Grade Squamous Intraepithelial Lesions Malignant Neoplasms Neck Neoplasms Patients Youth
Most episodes of HPV infection and many CIN1 and CIN2 cases are transient and will not develop into CIN3 or cancer.28 (link)–30 (link) The potential harms associated with detecting these transient lesions include the anxiety associated with a “positive” cancer screening test, potential stigmatization from the diagnosis of a sexually transmitted infection, discomfort from additional diagnostic and treatment procedures, bleeding from treatment, and, longer term, an increased risk of pregnancy complications such as preterm delivery due to treatment31 (link). Having a positive test at any point in one’s life may contribute to a perception of an increased risk of cancer, and a subsequent desire for more testing, further increasing the likelihood of another positive test.32 (link) Although any false positive test has the potential for inducing anxiety or other psychological distress, quality-of-life instruments are rarely included in controlled clinical trials of screening. Because of this, we used the number of colposcopies, both alone and relative to CIN3+ and cancer detected, as the primary measure of harm, since colposcopies themselves are associated with physical discomfort, and are a necessary pre-requisite to more invasive treatments with greater short- and long-term risks of harms. Since the number of subjects undergoing colposcopy is usually reported in controlled studies, and more screening leads to more screen positives and therefore more colposcopy, it provides a surrogate for potential harm of screening analogous to the use of the detection of CIN3 as a surrogate for cervical cancer for potential benefits of screening.
Our basic tenets regarding risk and risk-based interventions were as follows:
We recognize that the women at different ages may have different tradeoffs in benefits and harms from screening. These differences are addressed through the development of age-specific screening recommendations.
Publication 2012
Anxiety Cancer Screening Tests Cervical Cancer Cervical Intraepithelial Neoplasia, Grade III Colposcopy Diagnosis Involuntary Treatment Malignant Neoplasms Papillomavirus Infections, Human Physical Examination Pregnancy Complications Premature Birth Psychological Distress Sexually Transmitted Diseases Transients Woman
The Study to Understand Cervical Cancer Early Endpoints and Determinants (SUCCEED) was established in November 2003. The catchment population is women referred to colposcopy at University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, due to an abnormal Pap diagnosis or a biopsy diagnosis of cervical intraepithelial neoplasia. OUHSC is the referral center for the state of Oklahoma, excluding Tulsa. Women were primarily referred to the OUHSC from the OUHSC dysplasia clinic (51%), private physicians (21%), and the OU Medical Center Women’s Clinic (10%); remaining referrals originated from Planned Parenthood® clinics or other medical facilities (e.g., Mary Mahoney Memorial Health Center). All women who were scheduled for colposcopy were identified but not contacted prior to their visit; only women who kept their appointments and consented at the time of their scheduled OUHSC visit were offered participation into SUCCEED. SUCCEED is a cross-sectional study; of the women who kept their appointment, we excluded women under 18 years of age (3%), women pregnant at the time of their visit (10%), women who had prior treatment with chemotherapy or radiation for any cancer (<1%), women identified as HIV-positive (<1%), women with previous hysterectomy (<1%) and women attending the clinic solely for vaginal colposcopy or other reasons (8%). Recruitment was completed September 2007. With the exception of enriching accrual of invasive cancers, the percent disease distribution of women enrolled in SUCCEED is representative of the catchment referral population of Oklahoma. Of eligible women, 55% enrolled in SUCCEED. Written informed consent was obtained from all eligible women enrolled into the study. SUCCEED was approved by the Institutional Review Boards at the OUHSC and the National Cancer Institute.
Publication 2009
Biopsy Cervical Cancer Cervical Dysplasia Colposcopy Diagnosis Ethics Committees, Research HIV Seropositivity Hysterectomy Malignant Neoplasms Pharmacotherapy Physicians Radiotherapy Vagina Woman
Participants featured in the current study were enrolled into SUCCEED starting in November 2003 and ending in September 2007. We recruited women referred to colposcopy at the University of Oklahoma Dysplasia Clinic based at the University of Oklahoma Health Sciences Center (OUHSC), with a recent abnormal Pap smear diagnosis or a biopsy diagnosis of CIN. Details of study design and inclusion criteria have been described elsewhere (11 (link)). Briefly, exclusion criteria included women who were less than 18 years-of-age, pregnant at the time of their visit, previously treated with chemotherapy or radiation for any cancer, or women scheduled for vaginal colposcopy. Written informed consent was obtained from all women enrolled into the study and Institutional Review Board approval was provided by OUHSC and the U.S. National Cancer Institute.
At the time of the analysis, 1899 women had been enrolled; of these, we excluded 16 from the present analyses due to missing HPV results and further excluded 213 women due to unsatisfactory cytology, constituting a study population of 1670 women with a median age of 25 years (18–81 years). Of these, the following groups were excluded from the analyses of type attribution in cervical disease, because they could not be assigned to a disease category: 41 women with negative cytology, histology, and HPV result, 73 women without histology result and nine women without cytology result in the
Publication 2009
Biopsy Cervix Diseases Colposcopy Cytological Techniques Diagnosis Ethics Committees, Research Malignant Neoplasms Pharmacotherapy Radiotherapy Vagina Vaginal Smears Woman
We modelled EQ VAS scores using ordinary least squares linear regression. Given the hypothesis under investigation, the model contained EQ-5D health state classifications as independent variables. In addition we included, first, the HADS classification, to appraise the possibility that the EQ-5D classifications pertaining to the principal morbidity were insufficient in themselves to explain health state values. Second, we included the MHLCS scores, anticipating that individuals who believed that they controlled their own health destinies would report higher subjective values of their health state. Finally, we included a range of socio-demographic variables, with no necessary expectation of sign on the coefficients, on the basis of previous reports of associations between health values and socio-demographic factors. Carstairs scores were not included as potential explanatory variables because they proved to be collinear with the majority of individual characteristics.
To assess the stability of any relationship, we modelled changes in the EQ VAS score over the 12 months between the two questionnaire arrays using, as independent variables, changes in the EQ-5D and in the HADS classifications, plus the socio-demographic variables. We investigated the impact of one further factor in this second model, hypothesising that EQ VAS scores reported at the second round of questionnaires would have been influenced by the allocation to trial arms, for two reasons. First, recruits to clinical trials necessarily accept that they cannot pre-determine the management method to which they will be assigned, yet agreement to be randomised need not imply indifference to the randomisation outcome. It is established that a preference for the new practice under investigation (i.e. an intervention not routinely available) is a principal explanation for volunteering to participate in trials [32 (link)], whilst an unwillingness to risk randomisation away from current practice was found to be a principal explanation for refusal to participate in TOMBOLA [33 (link)]. It is therefore likely than a prior preference for the new intervention (immediate colposcopy) was widespread amongst TOMBOLA recruits. Second, by 12 months, the cervical abnormalities detected in women randomised to the colposcopy arm would have been resolved according to protocol. A proportion of women randomised to current practice, however, remained under surveillance, and the uncertainties over their abnormalities remained unresolved. We therefore judge that women randomised to the current practice arm of the trial (surveillance) might rate their health as worse, by virtue of being denied the intervention which they had sought and of failing, in some cases, to have their uncertainties resolved.
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Publication 2008
4-amino-4'-hydroxylaminodiphenylsulfone Apathy Colposcopy Congenital Abnormality Diagnostic Self Evaluation Neck Woman

Most recents protocols related to «Colposcopy»

The costs (2021 Euros, €) of diagnostic tests (i.e., cytology, colposcopy and biopsy) were considered in the study and were retrieved from Portuguese official sources (Table 3) [20 , 21 ]. The consumption of healthcare resources was estimated based on the Portuguese legislation and the clinical consensus from the Portuguese Society of Gynecology on cervical cancer screening [2 , 17 ]. Unit costs of HPV tests were not considered, since it was assumed that the three HPV tests had the same purchase price. However, the cost of HPV genotyping was considered every time a Hybrid Capture® 2 test was performed because the test alone does not allow to differentiate HPV genotypes (Table 3) [22 ].

Use of healthcare resources and associated costs

Healthcare resourceUnit costsReference/source
HPV tests
Hybrid Capture® 20€Assumption
Cobas® 48000€Assumption
Aptima® HPV0€Assumption
HPV genotyping after Hybrid Capture® 2
HPV genotyping685.18€*Qiagen, 2021
Diagnostic tests
Cytology15.2€Diário da República, 2018 (Code 30,510)
Colposcopy14.5€Diário da República, 2018 (Code 48,180)
Colposcopy + Biopsy34.4€Diário da República, 2018 (Code 48,190)

*575£—a formula was used to convert Pounds into Euros [23 ]

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Publication 2023
Biopsy Cervical Cancer Colposcopy Cytological Techniques Genotype Hybrids Neck Tests, Diagnostic
The comparison between Aptima® HPV versus Hybrid Capture® 2 or Cobas® 4800 was performed considering the number of HPV tests and other diagnostic tests (i.e., cytology, colposcopy, and biopsy) that are avoided with an HPV test versus another. Cost savings resulting from the avoidance of carrying out further HPV tests and other diagnostic tests were estimated to assess the budget impact of using the Aptima® HPV test instead of the other two HPV tests. To compare these tests, it is considered that all women included in the cohort are tested. Since the process is cyclic and may last for a few years, we present the results for the scenarios where each woman is followed: (a) during a 2-year period and (b) until the first colposcopy. Additionally, a scenario where each woman is followed during a single year is presented in the sensitivity analysis.
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Publication 2023
Biopsy Colposcopy Cytological Techniques Hybrids Hypersensitivity Tests, Diagnostic Woman
The analytical model consists of a decision tree that simulates and compares the screening performance of each HPV testing strategy. The screening algorithm was developed based on the Portuguese legislation, the clinical consensus published by the Portuguese Society of Gynecology on cervical cancer screening, as well as on the opinion of a panel of clinical experts (Fig. 1) [2 , 17 ]. Details on the composition and the methodology of panel of clinical experts are available on the Additional file 1.

Cervical cancer screening decision tree

The analytical model simulates a cohort of 2,199,879 healthy women aged 25–60 years old. The hypothetical cohort moves between the model states, according to prespecified probabilities in each decision tree node, over a period of 2 years. These probabilities can be applied to estimate the number of women who followed each path within the screening algorithm and estimate the resulting costs and tests used.
According to clinical guidelines, women undergo routine screening for cervical cancer using the HPV test every 5 years. If the result of the HPV test is negative, women undergo routine screening again 5 years later. On the other hand, women testing positive for HPV serotypes 16/18 are referred for colposcopy, while women testing positive for other serotypes of HPV are referred for cytology. Women with a cytology showing ASCUS or worse are referred for colposcopy. Women with a normal result in the cytology are followed-up and re-tested for HPV after 12 months. Women re-testing negative return to routine screening and women re-testing positive are referred for colposcopy. Women with a colposcopy revealing conclusive results without high-grade histological lesions are followed-up and re-tested for HPV after 12 months (HPV-negative women return to routine screening and HPV-positive women undergo new colposcopy). Women with a colposcopy showing conclusive results with high-grade histological lesions undergo biopsy. Women undergo transformation zone (TZ) excision if they have a) inconclusive results in the colposcopy or b) a colposcopy with conclusive results without high-grade histological lesions after cytology High Grade Squamous Intraepithelial Lesion (HSIL). After biopsy results, women with CIN < 2 are followed-up and re-tested for HPV after 12 months (HPV-negative women return to routine screening and HPV-positive women undergo new colposcopy). Women with CIN ≥ 2 initiate treatment. Women with inconclusive results or conclusive results without high-grade histological lesions in the new colposcopy undergo TZ excision. Women with conclusive results with high-grade histological lesions in the new colposcopy repeat biopsy (Fig. 1). Both colposcopy and biopsy are assumed to be 100% sensitive and 100% specific [5 (link)].
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Publication 2023
Atypical Squamous Cells of Undetermined Significance BAD protein, human Biopsy Cancer Screening Cervical Cancer Colposcopy Cytological Techniques High-Grade Squamous Intraepithelial Lesions Human papillomavirus 16 Neck Simulate composite resin Woman
Seven tissue samples from of SCC and seven samples of healthy cervical tissue were used for microarray testing. Additionally, cervical tissue samples from 11 cases of chronic cervicitis, 16 cases of low-grade squamous intraepithelial lesion (LSIL), 20 cases of high-grade squamous intraepithelial lesion (HSIL), and 21 cases of cervical cancer were used to detect hsa_circ_0000276 expression. All samples were single HPV16-positive. From January 2019 to January 2022, samples were obtained from patients who underwent colposcopy at the Second Hospital of the Shanxi Medical University. The tissue specimens were independently diagnosed by two experienced clinical pathologists.
The inclusion criteria were as follows: (i) married women aged ≤ 65 years; (ii) residents of Taiyuan for > 1 year; and (iii) written informed consent provided. The exclusion criteria were as follows: (i) pregnant women; (ii) a history of hysterectomy; (iii) a history of treatment of cervical and vaginal diseases; and (iv) presence of other malignant tumors. Written informed consent was obtained from all study participants or their legal guardians. The Ethics Review Committee of the Second Hospital of the Shanxi Medical University approved this study [approval number (2019) YX No. (280)].
The operational protocol for cervical tissue collection was as follows. The doctor who performed the examination had > 2 years of experience. The lesion site was assessed, and if cervical cancer was considered, tissue was collected from: (1) the cancer site (two pieces of tissue [each approximately 5 mm in size] were clamped) and (2) the matching normal tissues (two pieces of tissues [each approximately 5 mm in size] were clamped at approximately 3–5 cm from the cancer site). After clamping, the tissues were placed in 10% neutral formalin for 6–12 h for fixation and processed within 24 h for routine pathological examination. The tissues were then collected in pre-cooled tubes and quickly snap frozen in liquid nitrogen.
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Publication 2023
Cervical Cancer Colposcopy Formalin Freezing High-Grade Squamous Intraepithelial Lesions Human papillomavirus 16 Hysterectomy Legal Guardians Low-Grade Squamous Intraepithelial Lesions Malignant Neoplasms Microarray Analysis Neck Nitrogen Pathologists Patients Physicians Pregnant Women Tissues Uterine Cervicitis Vaginal Diseases Woman
A rapid lateral flow assay (rLFA) (Abviris GmbH, Germany) to detect anti-HPV16-L1 antibodies will be performed first, at the point-of-care (POC), on a single drop of finger capillary blood (as described in Table 2), with qualitative readout. A positive result will address the participant to physical examination / colposcopy at the same visit. Then, a venous blood sample is drawn for a further quantitative read-out serological analysis (Supplementary Materials: Annex A1 und A2).

Procedures

Screening (day 0)Baseline (day 0)Follow-up(Day 1 up to 6 months)Follow-up (6 months)
Informed consent procedureXX
Eligibility checkXX
Case report form (REDCapTM)XXX
Point-of-care blood test (capillary sample) aX
Laboratory-based analysisbX
Cervico-vaginal smear self-sampling cXX
Physical examination / colposcopyXdXXd
UrineXdXd

a PrevoCheck® with qualitative readout

b Serum for PT Monitor® (quantitative analysis) and for Schistosomiasis antibodies

c Seegene Anyplex ™ II 28 HPV, QG-MPH, STI and GS tests

d Only if symptomatic, microscopy for detection of Schistosomiasis eggs

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Publication 2023
Anti-Antibodies Biological Assay Capillaries Colposcopy Eggs Fingers Hematologic Tests Human papillomavirus 16 Microscopy Physical Examination Point-of-Care Systems Schistosomiasis Self-Examination Serum Vaginal Smears Veins

Top products related to «Colposcopy»

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PreservCyt solution is a liquid-based cytology preservative used for the collection, transportation, and processing of cervical cell samples. It is designed to maintain the integrity and morphology of the collected cells, enabling effective cytological examination.
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PreservCyt is a liquid-based cytology solution used for the collection and preservation of cellular specimens. It is designed to collect and maintain the integrity of cell samples for subsequent analysis and testing.
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The ThinPrep system is a laboratory equipment product that prepares patient samples for cytological examination. It is designed to process and prepare cellular samples in a standardized manner to improve the quality and consistency of specimen slides for analysis.
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The ThinPrep Pap Test is a laboratory equipment product designed for the collection, preparation, and analysis of cervical cell samples. It is used to collect and process cellular samples from the cervix, which can then be examined for the presence of abnormal cells or other indicators of cervical health.
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SurePath is a liquid-based cytology system developed by BD for the collection, fixation, and preservation of cellular samples for clinical testing. It is designed to improve the quality and reliability of cytological specimens.
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SPSS is a software package used for statistical analysis. It provides a graphical user interface for data manipulation, statistical analysis, and visualization. SPSS offers a wide range of statistical techniques, including regression analysis, factor analysis, and time series analysis.
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The Cobas 4800 is an automated molecular diagnostics system designed for high-throughput testing. It is capable of processing a wide range of molecular assays, including those for infectious disease detection and screening. The Cobas 4800 system is designed to provide efficient, reliable, and accurate results for laboratory testing.
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Stata version 14 is a software package for data analysis, statistical modeling, and graphics. It provides a comprehensive set of tools for data management, analysis, and reporting. Stata version 14 includes a wide range of statistical techniques, including linear regression, logistic regression, time series analysis, and more. The software is designed to be user-friendly and offers a variety of data visualization options.
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More about "Colposcopy"

Colposcopy is a crucial diagnostic procedure used to visually examine the cervix, vagina, and vulva for signs of disease.
This non-invasive technique employs a specialized microscope called a colposcope to magnify the area and identify any abnormal growths or lesions.
Colposcopy is commonly used as a follow-up to abnormal Pap smear (or Papanicolaou test) results, helping clinicians diagnose and manage cervical cancer and other gynecological conditions.
The PreservCyt solution and ThinPrep Pap Test are commonly used in conjunction with colposcopy.
The PreservCyt solution is a liquid-based cytology method that preserves cervical cells, allowing for more accurate analysis.
The ThinPrep Pap Test is a type of Pap smear that uses the PreservCyt solution to prepare the sample, leading to improved cell preservation and detection of abnormalities.
Colposcopy provides a detailed, magnified view of the affected area, enhancing the ability to accurately identify and monitor precancerous changes.
This vital diagnostic tool plays a key role in cervical cancer screening and prevention efforts worldwide.
Clinicians may also utilize the QIAamp DNA Mini Kit to extract DNA from cervical samples for further analysis.
Other related terms and technologies include SurePath, a liquid-based cytology system; SPSS software, a statistical analysis tool; Cobas 4800, a molecular diagnostics system; and Stata version 14, a data analysis and statistical software.
These tools and techniques can be employed to support and complement the colposcopy procedure, providing a comprehensive approach to gynecological health management.
By incorporating these insights and related terms, researchers and clinicians can streamline their colposcopy research and optimize their protocols, leading to improved accuracy and reproducibility in the field of cervical cancer screening and management.