title: Is colposcopy necessary at twelve months after large loop excision of the transformation zone? A clinical audit.
abstract: OBJECTIVE
  The purpose of this study was to review outcomes from LLETZ (large loop excision of the transformation zone) procedures carried out for high-grade cervical intraepithelial neoplasia (CIN), in particular findings at colposcopy, cytology and HR-HPV(high-risk human papilloma virus) result to assess whether colposcopy provides any additional information in the management of women at 12 months.
  
  
  METHODS
  We retrospectively analysed 252 patients who had a LLETZ procedure for a HSIL (high-grade squamous intraepithelial lesion) between January 2005 and December 2010.
  
  
  RESULTS
  Eighty per cent of women who had a LLETZ procedure for HSIL were reviewed in our colposcopy clinic at 12 months after the procedure. Colposcopy at 12 months after LLETZ was documented as unsatisfactory for 30% of these women. The sensitivity of colposcopy at 12 months after LLETZ was 0.47, and the specificity was 0.95.
  
  
  CONCLUSIONS
  Colposcopy examination is an insensitive tool for detection of persisting HPV-related change after excision of high-grade CIN. Its usefulness to investigate persistent or recurrent HSIL is further reduced by the high rate of unsatisfactory colposcopy examinations after a LLETZ procedure. Papanicolaou smear and HRHPV tests may be adequate follow-up at 12 months after LLETZ for women at low risk of recurrence of HSIL.
authors.affiliation: Gynaecology Department, Modbury Hospital, Modbury, South Australia, Australia.
authors.forename: Valerie
authors.initials: V
authors.lastname: Thompson
authors.forename: Raymond
authors.initials: R
authors.lastname: Marin
mesh_terms: D000328:Adult; D003127:Colposcopy; D005260:Female; D006801:Humans; D008485:Medical Audit; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D018365:Neoplasm, Residual; D065006:Papanicolaou Test; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery / Q000821:virology; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000601:surgery / Q000821:virology
keywords: Colposcopy; cervical intraepithelial neoplasia; large loop excision of the transformation zone