Surveillance patterns of cervical cancer patients treated with conization alone

Int J Gynecol Cancer. 2020 Aug;30(8):1129-1135. doi: 10.1136/ijgc-2020-001338. Epub 2020 Jun 3.

Abstract

Objectives: To determine surveillance patterns of stage I cervical cancer after cervical conization.

Methods: A 25-question electronic survey was sent to members of the Society of Gynecologic Oncology. Provider demographics, surveillance during year 1, years 1-3, and >3 years after cervical conization, use of pelvic examination, cytology, Human papillomavirus testing, colposcopy, and endocervical curettage were queried. Data were analyzed.

Results: 239/1175 (20.1%) responses were collected over a 5-week study period. All providers identified as gynecologic oncologists. During year 1, 66.7% of providers perform pelvic examination and 37.1% perform cytology every 3 months. During years 1-3, 61.6% perform pelvic examination and 46% perform cytology every 6 months. At >3 years, 54.4% perform pelvic examination every 6 months and 43% perform annual pelvic examination. 66.7% of respondents perform cytology annually, and 51.9% perform annual Human papilloma virus testing. 85% of providers do not offer routine colposcopy and 60% do not offer endocervical curettage at any point during 5-year follow-up. 76.3% of respondents screen patients for Human papilloma virus vaccination.

Conclusions: To date, there are no specific surveillance guidelines for patients with stage I cervical cancer treated with cervical conization. The most common surveillance practice reported is pelvic examination with or without cytology every 3 months in year 1 and every 6 months thereafter. However, wide variation exists in visit frequency, cytology, and Human papillomavirus testing, and there is a clear trend away from using colposcopy and endocervical curettage. These disparate surveillance practices indicate a need for well-defined, uniform surveillance guidelines.

Keywords: cervical cancer; surgical oncology; surgical procedures, operative.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Age Factors
  • Cervix Uteri / surgery
  • Colposcopy / statistics & numerical data
  • Conization
  • Cytodiagnosis / statistics & numerical data
  • Female
  • Fertility Preservation
  • Gynecological Examination / statistics & numerical data
  • Humans
  • Hysterectomy / statistics & numerical data
  • Institutional Practice / statistics & numerical data
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Staging
  • Papillomavirus Infections / diagnosis
  • Papillomavirus Infections / prevention & control
  • Population Surveillance / methods*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Private Practice / statistics & numerical data
  • Surveys and Questionnaires
  • Time Factors
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / pathology*
  • Uterine Cervical Neoplasms / surgery
  • Vaccination