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#1115 Management of high grade cervical intraepithelial neoplasia (HG-CGIN) during the COVID-19 pandemic
  1. Aditi Kishore Shinde,
  2. Jane Rains and
  3. Gulnaz Majeed
  1. Guys and St Thomas Hospital, London, UK


Introduction/Background Adenocarcinomas form 10–15 % of all cervical cancers. Despite a national screening programme the incidence of adenocarcinoma in situ (AIS) and adenocarcinoma increasing. The objective of this audit was to determine the impact of the covid-19 pandemic on the management of high grade cervical glandular lesions.

Methodology The viewpoint database was reviewed from 1rst January 2019 to 31 December 2021. Cyres is the link used for quality assurance. The following parameters were assessed: number, histopathological subtype and surgical margins, treatment received, documented colposcopy MDM discussion, type of excision, repeat excisional procedure, follow-up, test of cure (HPV and cytology).

Results 24 patients were reffered with possibility of glandular neoplasia as referral cytology. 25% patients were seen within 2 weeks from referral, with median wait times being 8 days.

A diagnostic rate for high grade cervical glandular lesion was 60.86% on colposcopy directed biopsy. There was 46.6% concordance between LLETZ and colposcopy opinion with 13.6% lesions being upgraded and 16.6% patient being downgraded. There was a 46.15% concordance between colposcopy directed biopsy and LLETZ, with 17.39% lesions upgraded and 13.04% lesions downgraded. Margins were involved in 47.61% of women and almost 1 in 4 women required a repeat procedure. 1 in 3 women who had a second LLETZ procedure had a high grade glandular histopathology. 91.3% women had Colposcopy MDM discussion. 69.5% had first test of cure for high risk HPV and 13.04% had second test of cure.

Conclusion Despite the covid-19 pandemic we provided standard care and compliance with the 2 WW referral pathways and follow-up for high grade cervical lesions. We recommend a change in practice from colposcopy directed biopsy to excisional biopsy for HG-CGIN detected on colposcopy

Disclosures None

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