Objectives To determine surveillance patterns of Stage I cervical cancer after cervical conization (CC) in the United States.
Methods A 25-question electronic survey was sent to members of the Society of Gynecologic Oncology. Provider demographics, surveillance during first year (Y1), years 1–3 (Y13) and >3 years (Y3+) after CC, use of pelvic exam, cytology, HPV testing, colposcopy and endocervical curettage (ECC) were queried. Data were analyzed.
Results 185/1381 (13%) responses were collected: all providers identified as gynecologic oncologists and characteristics shown in figure 1. Y1, 66% of providers perform pelvic exam and 35% cytology every (q) 3 months (figure 2). Y13, 60% perform pelvic exam and 46% cytology q6 months. Y3+, 54% perform pelvic exam q6 months and 67% cytology annually. HPV testing was not offered by 28% of providers at any point during 5-year follow-up. 52% recommend annual HPV testing Y3+ following CC. 86% of providers do not offer routine colposcopy and 71% do not offer ECC at any point during 5-year follow up. 75% screen patients for HPV vaccination. Surveillance results impact decisions for post-CC hysterectomy (figure 3).
Conclusions To date, there are no specific surveillance guidelines for Stage I cervical cancer treated with CC. The most common surveillance practice reported is q3 month pelvic exam with or without cytology in Y1 and q6 month thereafter. However, wide variation exists in visit frequency, cytology and HPV testing, and a clear trend away from using colposcopy and ECC. This disparate surveillance strategy provides an opportunity to define uniform surveillance guidelines.
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