The incidence of cervical cancer in women with postcoital bleeding and abnormal appearance of the cervix referred through the 2‐week wait pathway in the United Kingdom: a retrospective cohort study

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Authors
Jasper, Brittany
Thorley, Emma
Martins, Filipe Correia
Haldar, Krishnayan
Issue Date
2022-07-30
Type
Article
Language
en_US
Keywords
Cervical Intraepithelial Neoplasia , Colposcopy , Incidence , Referral and Consultation , Uterine Cervical Neoplasms
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Abstract
Aim: To determine the incidence of cervical cancer in women referred through the 2‐week‐wait pathway for postcoital bleeding and abnormal appearance of the cervix. Methods: A retrospective cohort study was conducted of women with postcoital bleeding, or abnormal appearance of the cervix referred to colposcopy clinics through the 2‐week‐wait pathway for suspected cervical cancer at Cambridge University Hospitals in the United Kingdom over 5 years. Women were identified from a departmental database. Clinical and demographic data were collected. Categorical data was analyzed with chi‐squared or Fisher's exact tests and predictive values were calculated. Results: Of the 604 women referred, 1.16% were diagnosed with cervical cancer. None of the women who were up‐to‐date with cervical screening were diagnosed with cervical cancer, while 6.25% of women out‐of‐date with cervical screening or outside the screening age group were diagnosed with cervical cancer (p < 0.001). The positive predictive value for diagnosing cervical cancer was 1.70% for postcoital bleeding (95% confidence interval [CI] 0.64–3.7) and 0.31% for abnormal appearance of the cervix (95% CI 0.0008–1.7). Conclusions: The incidence of cervical cancer in women referred through the 2‐week‐wait pathway for postcoital bleeding and abnormal appearance of the cervix is low. These referrals have considerable implications for both patients and clinicians, and have a low predictive value for diagnosing cervical cancer. In light of emerging evidence and changing practices, referral guidelines should be reviewed based on up‐to‐date data and current practices.
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Jasper, B., Thorley, E., Martins, F. C., & Haldar, K. (2022). The incidence of cervical cancer in women with postcoital bleeding and abnormal appearance of the cervix referred through the 2-week wait pathway in the United Kingdom: A retrospective cohort study. The journal of obstetrics and gynaecology research, 48(11), 2872–2878. https://doi.org/10.1111/jog.15366
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The Journal of Obstetrics and Gynaecology Research
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