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Same day colposcopic examination and loop electrosurgical excision procedure (LEEP) presents minimal overtreatment and averts delay in treatment of cervical intraepithelial …

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dc.contributor.author Kays Muruka, Mugo R Nelly, Wanyoike Gichuhi, Kihara Anne-Beatrice, Cheserem J Eunice, Kosgei J Rose
dc.date.accessioned 2020-08-28T10:06:23Z
dc.date.available 2020-08-28T10:06:23Z
dc.date.issued 2013-05-08
dc.identifier.citation 6 en_US
dc.identifier.uri https://repository.maseno.ac.ke/handle/123456789/2566
dc.description Published Online May 2013 (http://www.scirp.org/journal/ojog/) en_US
dc.description.abstract Background: Screening for cancer of the cervix at Kenyatta National Hospital (KNH), follows the recommended three-step strategy; Papanicolaou (Pap) smear, colposcopy/biopsy and loop electrosurgical excision procedure (LEEP)/biopsy. This approach poses the following challenges: multiple clinic visits, costly, time consuming, long turnaround time to treatment, non-compliance and loss-to-follow-up. Objective: To determine the agreement between histologies following colposcopy and LEEP amongst women in KNH as a forerunner for opportunity to shift from the three-step approach to the two-step “see and treat” (same-day colposcopy and LEEP) approach. Methods: This was a retrospective descriptive cohort of Women who underwent LEEP procedure between January 2008 and 31st December 2010 following the three-step approach at KNH, Kenya. Results: A total of 124 patients out of the 132 patients who underwent LEEP were included in the analysis. The 8 patients excluded had missing files. HIV infected, uninfected or unknown women are similar socio-demographically. The mean (SD) age for the HIV infected, uninfected and unknown is 37 (6), 33 (10) and 35 (9) years respectively. Colposcopic and LEEP biopsy histology within patients demonstrated a high weighted kappa statistics agreement of 84%. LEEP increased diagnosis of invasive cancer. Patients had a median (IQR) 5 (4 - 6) clinic visits from Pap smear to LEEP treatment. It took median (IQR) 55 (27 - 116) days between Pap smear to colposcopy result and 167 (101 - 276) days between Pap smear results to LEEP treatment. If a LEEP procedure were to be performed in this cohort of women on the same day of the colposcopy biopsy a median (IQR) 77 (55 - 137) days could have been saved. Conclusion: There is a high agreement between colposcopy and LEEP biopsies in our setting offering a window of opportunity to perform “See and Treat” same-day colposcopy and LEEP treatment procedure, skipping the colposcopy biopsy stage. en_US
dc.publisher Scientific Research Publishing en_US
dc.subject Colposcopy; Loop Electrosurgical Excision Procedure (LEEP); CIN; Cervical Cancer Screening en_US
dc.title Same day colposcopic examination and loop electrosurgical excision procedure (LEEP) presents minimal overtreatment and averts delay in treatment of cervical intraepithelial … en_US
dc.type Article en_US


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