The following is a summary of “Guideline-Concordant Surveillance After Treatment for High-Grade Cervical Dysplasia,” published in the March 2025 issue of Obstetrics & Gynecology by Wang et al.
Researchers conducted a retrospective study to measure the number of individuals treated for high-grade cervical dysplasia who completed guideline-concordant surveillance.
They assessed individuals aged 30–65 who were treated for high-grade cervical dysplasia (cervical intraepithelial neoplasia 2 or worse) at 2 PROSPR II METRICS (Population-based Research to Optimize the Screening Process Multi-level Optimization of the Cervical Cancer Screening Process in Diverse Settings & Populations sites) (Massachusetts General Brigham, Parkland Health) from 2010 to 2019. The primary outcome was completing 2 negative co-tests within 30 months post-treatment, allowing a 6-month scheduling leeway.
The results showed that among 3,146 individuals treated for high-grade dysplasia, most were aged 30–39 years (Massachusetts General Brigham 58.9%, Parkland Health 60.9%) and had minimal or no comorbidities (Massachusetts General Brigham 81.2%, Parkland Health 85.6%). Demographics, insurance coverage, and socioeconomic factors reflected the broader population. Only 45.5% completed 2 surveillance co-tests within 30 months post-treatment (Massachusetts General Brigham 55.3%, Parkland Health 40.6%), and of these, about one-third had at least 1 abnormal result (Massachusetts General Brigham 30.9%, Parkland Health 31.6%). Those who completed 2 co-tests remained under observation longer (median Massachusetts General Brigham 64.9 months vs 33.1 months, median Parkland Health 63.9 months vs 41.8 months). Among these individuals, surveillance co-testing largely followed guidelines (median [interquartile range] time to first co-test: Massachusetts General Brigham 6.4 [5.1–9.2] months, Parkland Health 10.1 [6.6–12.6] months; median [interquartile range] time between first and second co-test: Massachusetts General Brigham 8.5 [6.0–12.6] months, Parkland Health 12.0 [8.0–13.5] months). A total of 16 individuals (0.5%) developed cervical cancer post-treatment (median [interquartile range] time from treatment to cancer diagnosis 14.9 [3.8–45.9] months).
Investigators concluded that a significant portion of patients did not receive recommended follow-up after high-grade dysplasia treatment.
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