ArticleBJOG : an international journal of obstetrics and gynaecology2022
Cervical intraepithelial neoplasia in women with transformation zone type 3: cervical biopsy versus large loop excision.
Article in BJOG : an international journal of obstetrics and gynaecology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- The overtreatment rate, medical cost and psychological affection of see-and-treat versus three-step approaches in the treatment of cervical intraepithelial neoplasia: a systematic review and meta-analysis.BMC women's health · 2025Pooled it
- Value of a catch-up HPV test in women aged 65 and above: A Danish population-based nonrandomized intervention study.PLoS medicine · 2023Trial
- Differential diagnostic value of PAX1 and JAM3 methylation for cervical intraepithelial neoplasia between premenopausal and postmenopausal women: a retrospective clinical study in China.Annals of medicine · 2026Article
- Assessing the clinical value of cervical biopsies in individuals with transformation zone type 3 at colposcopy: A cross-sectional study.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Beyond HPV in Eastern Europe: Genotype Distribution, Molecular Biomarkers, Vaginal Microbiome, and Implications for Cervical Cancer Prevention.Life (Basel, Switzerland) · 2026Review
- Additional Diagnostic Yield of Endocervical Curettage in Type 3 Transformation Zone for High-Grade Cervical Lesions: A Retrospective Analysis by Human Papillomavirus Genotype.Diagnostics (Basel, Switzerland) · 2026Article
- Cervical Cancer Screening with Visual Inspection with Acetic Acid (VIA) among Women Living with HIV in Nairobi, Kenya: Results and Transformation Zone.medRxiv : the preprint server for health sciences · 2026Article
- Predictive Value of Positive Endocervical Curettage Results Obtained During Colposcopy.Diagnostics (Basel, Switzerland) · 2026Article
- Enhanced diagnostic accuracy of high-grade cervical intraepithelial neoplasia in postmenopausal women through PAX1/JAM3 methylation analysis.International journal of cancer · 2026Article
- Demographic and Screening-to-Diagnosis Cascade Indicators for Risk Stratification in an Organized Cervical Cancer Screening Program: Evidence from 82,141 Women in Yunnan, China.International journal of women's health · 2026Article
- Risk Factors for Occult Invasive Cervical Cancer in Women with Abnormal Cervical Screening and Infeasible Diagnostic Conization.International journal of women's health · 2026Article
- Negative margins and negative HPV tests after large loop excision of the transformation zone: A nationwide historical cohort study.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Risk factors of histologic upgrade between colposcopy-directed biopsy and loop electrosurgical excision procedure in cervical squamous intraepithelial lesions: a retrospective study.Frontiers in medicine · 2026Article
- Outcomes associated with large loop excision of the cervical transformation zone in women 60-64 years of age: A population-based register study from Denmark.Acta obstetricia et gynecologica Scandinavica · 2025Article
- Risk factors of human papillomavirus-related cervical lesions in postmenopausal women: a cross-sectional study.BMC women's health · 2025Article
- High rate of persistent HPV detection after diagnostic cervical excision in older screen-positive women.Acta obstetricia et gynecologica Scandinavica · 2025Article
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- A Glimmer of Hope for Patients with a T3 Transformation Zone: miRNAs Are Potential Biomarkers for Cervical Dysplasia.Diagnostics (Basel, Switzerland) · 2023Article
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
Abstract
objectiveTo compare the proportion of cervical intraepithelial neoplasia grade 2 or higher (CIN2+) in cervical biopsies with that in large loop excision of the transformation zone (LLETZ) specimens in women aged ≥45 years with transformation zone type 3 (TZ3).
designMulticentre cross-sectional study.
settingThree colposcopy clinics in the Central Denmark Region. POPULATION: Women aged ≥45 years referred to colposcopy as a result of a positive human papillomavirus (HPV) test and/or abnormal cytology and with TZ3 at colposcopy.
methodsWomen had multiple biopsies taken and an LLETZ was performed.
main outcome measuresHistologically confirmed CIN2+ in biopsies compared with that in LLETZ specimens.
resultsOf 166 eligible women at colposcopy, 102 women with paired data from biopsies and LLETZ specimens were included for final analysis. The median age was 67.7 years (IQR 62.6-70.4 years), and most were postmenopausal (94.1%) and had undergone HPV-based screening (81.3%). The CIN2+ detection rate was significantly higher in LLETZ specimens than in biopsies (32.4% vs 14.7%, difference 17.7%, 95% CI 6.3-29.0%), resulting in more than half of CIN2+ cases being missed in biopsies (54.5%, 95% CI 36.4-71.9%). The overall agreement between biopsies and LLETZ was 82.4% (95% CI 73.6-89.2%).
conclusionsCIN2+ detection is underestimated in women aged ≥45 years with TZ3 if detection relies on the results of biopsies alone. To reduce the risk of underdiagnosis and overtreatment, future studies should explore the use of new biomarkers for risk stratification to improve discrimination between women at increased risk of CIN2+ who need to undergo LLETZ and women who may undergo follow-up.
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