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Rate of detecting CIN3+ among patients with ASC‑US using digital colposcopy and dynamic spectral imaging

  • Authors:
    • Karen Eloise Harris
    • Philip Todd Lavin
    • Mark Donnell Akin
    • Emmanouil Papagiannakis
    • Sara Denardis
  • View Affiliations / Copyright

    Affiliations: Department of Obstetrics and Gynecology, College of Medicine, University of Central Florida, Gainesville, FL 32605, USA, Boston Biostatistics Research Foundation, Framingham, MA 01702‑6105, USA, Austin Area Obstetrics, Gynecology and Fertility, Austin, TX 78758, USA, DYSIS Medical, Edinburgh EH12 9DQ, UK, Department of Obstetrics/Gynecology, University of Central Florida, Orlando, FL 32827, USA
    Copyright: © Harris et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 17
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    Published online on: July 16, 2020
       https://doi.org/10.3892/ol.2020.11878
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Abstract

The present study compared two methods for the detection of severe cervical dysplasia in women with atypical squamous cells of underdetermined significance (ASC‑US) cytology; digital colposcopy with adjunctive dynamic spectral imaging (DSI) and conventional colposcopy. IMPROVE‑COLPO was a two‑arm cross‑sectional study of US community‑based colposcopy. The active (prospective) arm of this study recruited patients examined by digital colposcopy and adjunctive DSI. Preceding consecutive patients that had been examined with conventional methods were used as historical controls in the retrospective arm of the study after being matched in number to those in the prospective arm by a colposcopist. In the present study, the primary measure was the number of women detected with cervical intraepithelial neoplasia (CIN) grade 3 or worse (CIN3+) following punch biopsy. The study included 1,353 retrospective and 1,226 prospective patients eligible for this analysis who were examined by 146 colposcopists in 42 community‑based clinics. The patient baseline characteristics were comparable between the two arms. The average number of biopsies taken per patient was higher among the prospective arm patients (including standard and DSI‑assisted biopsies) compared with the retrospective arm control patients (1.21 vs. 0.97 respectively). Biopsy detected 31 patients with CIN3+ [2.29%; 95% confidence interval (CI), 1.56‑3.24] in the retrospective arm, and 48 patients with CIN3+ (3.92%; 95% CI, 2.90‑5.16) in the prospective arm. The difference in the number of patients detected with CIN3+ in the two arms of the study was 1.62% (95% CI, 0.30‑3.04; P=0.022), which corresponds to a 70.9% relative increase in the prospective compared with the retrospective arm. Biopsy appeared less efficient in detecting patients with CIN3+ in the retrospective arm compared with the prospective arm. However, there was no statistically significant difference between the retrospective arm and the prospective arm in terms of: i) Biopsies taken (over the entire population) per patient detected with CIN3+ (42.2 in the retrospective arm vs. 30.8 in the prospective arm; P=0.164) and ii) positive predictive value of using biopsies to identify patients with CIN3+ (2.83 vs. 3.92; P=0.118). Adoption of digital colposcopy with DSI increased the number of biopsies collected from ASC‑US patients compared with retrospective controls of standard colposcopy and detected a significantly higher number of patients who were CIN3+. The number of additional biopsies taken in the prospective arm compared with the retrospective arm was too small to explain the increased detection of patients with CIN3+ observed in the prospective arm, suggesting that biopsies in the prospective arm were better at identifying CIN3+.
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Copy and paste a formatted citation
Spandidos Publications style
Harris KE, Lavin PT, Akin MD, Papagiannakis E and Denardis S: Rate of detecting CIN3+ among patients with ASC‑US using digital colposcopy and dynamic spectral imaging. Oncol Lett 20: 17, 2020.
APA
Harris, K.E., Lavin, P.T., Akin, M.D., Papagiannakis, E., & Denardis, S. (2020). Rate of detecting CIN3+ among patients with ASC‑US using digital colposcopy and dynamic spectral imaging. Oncology Letters, 20, 17. https://doi.org/10.3892/ol.2020.11878
MLA
Harris, K. E., Lavin, P. T., Akin, M. D., Papagiannakis, E., Denardis, S."Rate of detecting CIN3+ among patients with ASC‑US using digital colposcopy and dynamic spectral imaging". Oncology Letters 20.4 (2020): 17.
Chicago
Harris, K. E., Lavin, P. T., Akin, M. D., Papagiannakis, E., Denardis, S."Rate of detecting CIN3+ among patients with ASC‑US using digital colposcopy and dynamic spectral imaging". Oncology Letters 20, no. 4 (2020): 17. https://doi.org/10.3892/ol.2020.11878
Copy and paste a formatted citation
x
Spandidos Publications style
Harris KE, Lavin PT, Akin MD, Papagiannakis E and Denardis S: Rate of detecting CIN3+ among patients with ASC‑US using digital colposcopy and dynamic spectral imaging. Oncol Lett 20: 17, 2020.
APA
Harris, K.E., Lavin, P.T., Akin, M.D., Papagiannakis, E., & Denardis, S. (2020). Rate of detecting CIN3+ among patients with ASC‑US using digital colposcopy and dynamic spectral imaging. Oncology Letters, 20, 17. https://doi.org/10.3892/ol.2020.11878
MLA
Harris, K. E., Lavin, P. T., Akin, M. D., Papagiannakis, E., Denardis, S."Rate of detecting CIN3+ among patients with ASC‑US using digital colposcopy and dynamic spectral imaging". Oncology Letters 20.4 (2020): 17.
Chicago
Harris, K. E., Lavin, P. T., Akin, M. D., Papagiannakis, E., Denardis, S."Rate of detecting CIN3+ among patients with ASC‑US using digital colposcopy and dynamic spectral imaging". Oncology Letters 20, no. 4 (2020): 17. https://doi.org/10.3892/ol.2020.11878
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