Reduction in colposcopy workload and associated clinical activity following HPV catch-up vaccination programme in Scotland : an ecological study

Cruickshank, M E and Pan, J. and Cotton, SC and Kavanagh, K and Robertson, C and Cuschieri, K and Cubie, H and Palmer, T and Pollock, KG (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, 124 (9). pp. 1386-1293. ISSN 1470-0328 (https://doi.org/10.1111/1471-0528.14562)

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Abstract

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.

ORCID iDs

Cruickshank, M E, Pan, J. ORCID logoORCID: https://orcid.org/0000-0001-5993-3209, Cotton, SC, Kavanagh, K ORCID logoORCID: https://orcid.org/0000-0002-2679-5409, Robertson, C, Cuschieri, K, Cubie, H, Palmer, T and Pollock, KG;
  • Item type:Article
    ID code:59423
    Dates:
    Date
    Event
    20 July 2017
    Published
    9 March 2017
    Published Online
    31 December 2016
    Accepted
    Notes: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 © 2017 Royal College of Obstetricians and Gynaecologists Cruickshank ME, Pan J, Cotton SC, Kavanagh K, Robertson C, Cuschieri K, Cubie H, Palmer T, Pollock KG. Reduction in colposcopy workload and associated clinical activity following human papillomavirus (HPV) catch-up vaccination programme in Scotland: an ecological study. BJOG 2017; 124: 1386–1393.
    Subjects:Medicine > Gynecology and obstetrics
    Science > Mathematics
    Department:Faculty of Science > Mathematics and Statistics
    Strategic Research Themes > Health and Wellbeing
    Depositing user: Pure Administrator
    Date deposited:13 Jan 2017 11:16
    Last modified:11 Nov 2024 11:36
    Related URLs:
    URI:https://strathprints.strath.ac.uk/id/eprint/59423
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