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. ISSN 1470-0328 (In Press) (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
    11 January 2017
    Published
    11 January 2017
    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
    Keywords:HPV, HPV vaccination, immunisation, cervical screening, colposcopy, loop excision, Scottish Cervical Screening Programme , human papillomavirus , Gynecology and obstetrics, Obstetrics and Gynaecology
    Subjects:Medicine > Gynecology and obstetrics
    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:28 Mar 2023 09:42
    Related URLs:
    URI:https://strathprints.strath.ac.uk/id/eprint/59423
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