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Journal of Oncology
Volume 2016, Article ID 3056407, 5 pages
http://dx.doi.org/10.1155/2016/3056407
Research Article

Excisional Treatment of Cervical Dysplasia in Australia 2004–2013: A Population-Based Study

1University of New South Wales, School of Women’s and Children’s Health, Randwick, Sydney, NSW 2031, Australia
2Centre for Gynaecological Oncology, Royal Hospital for Women, Randwick, Sydney, NSW 2031, Australia
3Australian National University Medical School, Garran, ACT 2605, Australia

Received 8 February 2016; Accepted 13 April 2016

Academic Editor: John R. Van Nagell

Copyright © 2016 Gregory Robertson and Stephen J. Robson. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Excisional treatment of preinvasive cervical dysplasia has been associated with adverse pregnancy outcomes. We aimed to examine trends in the rate of excisional treatment in reproductive age women in the era of HPV vaccination. Methods. National data for Australia regarding histological diagnoses of cervical dysplasia and excisional treatment for the period from 2004 to 2013 inclusive were obtained from two datasets and used to calculate age-stratified incidence rates of excisional treatment and of excisional treatments per diagnosis of dysplasia. Results. The incidence of low-grade squamous dysplasia fell in all age groups, while the incidence of high-grade dysplasia fell in the 20-to-24-year group but rose slightly for older age groups. The rate of excisional treatment fell in women aged under 35 but there was no significant change for women 35 years or older. The rate of all excisional treatments (loop excision + cone biopsy) per high-grade diagnosis (CIN2 + CIN3 + adenocarcinoma in situ) fell across all three age-bands in both datasets. Conclusion. To ensure that the use of excisional treatment is appropriate, with lower rates for younger HPV-vaccinated women, close surveillance, audit, and ongoing education will be required.