TY - JOUR
T1 - Reduction in colposcopy workload and associated clinical activity following HPV catch-up vaccination programme in Scotland
T2 - an ecological study
AU - Cruickshank, M E
AU - Pan, J.
AU - Cotton, SC
AU - Kavanagh, K
AU - Robertson, C
AU - Cuschieri, K
AU - Cubie, H
AU - Palmer, T
AU - Pollock, KG
N1 - This is the peer reviewed version of the following article: Cruickshank, M. E., Pan, J., Cotton, S. C., Kavanagh, K., Robertson, C., Cuschieri, K., ... Pollock, K. G. (2017). Reduction in colposcopy workload and associated clinical activity following HPV catch-up vaccination programme in Scotland: an ecological study. BJOG: An International Journal of Obstetrics and Gynaecology, which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving
PY - 2017/1/11
Y1 - 2017/1/11
N2 - Objective: To measure patterns of clinical activity at colposcopy before and after vaccinated women entered the Scottish Cervical Screening Programme (SCSP).
Design: Population-based observational study using nationally collected data.
Setting: Scottish colposcopy clinics.
Sample: All women with a date of birth on or after 1 January 1985 who attended colposcopy in Scotland between 2008-2014.
Methods: Routinely collected data from the Scottish National Colposcopy Clinical Information Audit System (NCCIAS) was extracted, including: referral criteria, referral cervical cytology, colposcopic findings, clinical procedures and histology results. Analysis was restricted to those referred to colposcopy at age 20 or 21 years.
Main outcome measures: Referral criteria, positive predictive value of colposcopy, default rates and rates of cervical biopsies and treatments.
Results: 7372 women referred for colposcopy at age 20/ 21 years were identified. There was a downward trend in the proportion of those referred with abnormal cytology (2008/9: 91.0%, 2013/14: 90.3%, linear trend p value = 0.03). Women were less likely to have diagnostic or therapeutic interventions. The proportion with no biopsy (2008/9: 19.5%, 2013/14: 26.9%, linear trend p value < 0.0001) and no treatment (2008/9: 74.9%, 2013/14: 91.8%, linear trend p value < 0.0001) increased over the period of observation.
Conclusions: A reduction in clinical activity related to abnormal screening referrals is likely to be associated with the HPV catch-up immunisation programme. Referral criteria and service provision of colposcopy needs to be planned carefully taking account of the increasing number of HPV- immunised women that will be entering cervical screening programmes worldwide.
AB - Objective: To measure patterns of clinical activity at colposcopy before and after vaccinated women entered the Scottish Cervical Screening Programme (SCSP).
Design: Population-based observational study using nationally collected data.
Setting: Scottish colposcopy clinics.
Sample: All women with a date of birth on or after 1 January 1985 who attended colposcopy in Scotland between 2008-2014.
Methods: Routinely collected data from the Scottish National Colposcopy Clinical Information Audit System (NCCIAS) was extracted, including: referral criteria, referral cervical cytology, colposcopic findings, clinical procedures and histology results. Analysis was restricted to those referred to colposcopy at age 20 or 21 years.
Main outcome measures: Referral criteria, positive predictive value of colposcopy, default rates and rates of cervical biopsies and treatments.
Results: 7372 women referred for colposcopy at age 20/ 21 years were identified. There was a downward trend in the proportion of those referred with abnormal cytology (2008/9: 91.0%, 2013/14: 90.3%, linear trend p value = 0.03). Women were less likely to have diagnostic or therapeutic interventions. The proportion with no biopsy (2008/9: 19.5%, 2013/14: 26.9%, linear trend p value < 0.0001) and no treatment (2008/9: 74.9%, 2013/14: 91.8%, linear trend p value < 0.0001) increased over the period of observation.
Conclusions: A reduction in clinical activity related to abnormal screening referrals is likely to be associated with the HPV catch-up immunisation programme. Referral criteria and service provision of colposcopy needs to be planned carefully taking account of the increasing number of HPV- immunised women that will be entering cervical screening programmes worldwide.
KW - HPV
KW - HPV vaccination
KW - immunisation
KW - cervical screening
KW - colposcopy
KW - loop excision
KW - Scottish Cervical Screening Programme
KW - human papillomavirus
UR - http://obgyn.onlinelibrary.wiley.com/hub/journal/10.1111/(ISSN)1471-0528/
U2 - 10.1111/1471-0528.14562
DO - 10.1111/1471-0528.14562
M3 - Article
JO - BJOG: An International Journal of Obstetrics and Gynaecology
JF - BJOG: An International Journal of Obstetrics and Gynaecology
SN - 1470-0328
ER -