Table 3.
Diagnostic and Treatment Follow-up
| First Author |
Year | Diagno stic follow- up |
Same day diagnosis/R eferred |
Loss to follow -up for colpos copy |
Loss to follo w-up for biops y |
Reasons for loss to follow up |
Inform ation regardi ng treatme nt provide d? |
Same visit cryothe rapy |
Treatment strategy
|
||
|---|---|---|---|---|---|---|---|---|---|---|---|
| CIN1 | CIN2/3 | Invasiv e cancer |
|||||||||
| Sankaranarayanan et al.[17] | 1998 | Colposcopy and Histology | Referred | 10% | Not reported | Not reported | Yes | Not reported | 77 cases of mild dysplasia were considered as false positives and not treated. | ||
| Basu et al.[6] | 2003 | Colposcopy and Histology | Same day | 0% | 11.60 % | Biopsies were not obtained or inadequate or inconclusive in these cases | Yes | Unclear | Of 336 women detected with low grade lesions, 127 had cryotherapy and two had LEEP. A total of 207 (61.6%) did not receive treatment | Of the 122 women detected with high grade lesions, 48 had cryotherapy, 20 had LEEP, and three had conisation. A total of 51 (41.8%) women did not receive treatment. | |
| Sankaranarayanan et al.[18] | 2003 | Colposcopy and Histology | Same day | 0% | Not reported | Not reported | Not reported | Not reported | Not reported | ||
| Sankaranarayanan et al.[19] | 2004 | Colposcopy and Histology | Same day | Not reported | Not reported | Not reported | Not reported | Not reported | Not reported | ||
| Sankaranarayanan et al.[20] | 2004 | Colposcopy and Histology | Same day | 0% | Not reported | Not reported | Not reported | Not reported | Not reported | ||
| Basu et al.[9] | 2006 | Colposcopy and Histology | Same day | 0% | 4.40 % | Women refused | Yes | No | Treated appropriately after biopsy results | ||
| Kamal et al.[21] | 2007 | Colposcopy | Same day | 0% | Not reported | Not reported | Not reported | Not reported | Not reported | ||
| Colposcopy | Referred | 84% | Not reported | Referral | Not reported | Not reported | Not reported | ||||
| Nene et al.[22] | 2007 | Colposcopy and Histology | Same day | 1.40% | Not reported | Not reported | Yes | No | 80% of the women with CIN 1 received treatment | Women with moderate to severe CIN (CIN2+) were treated with cryotherapy as eligible and/or referred for further management. Overall, 85% with CIN 2 and 88% with CIN 3 received treatment and approximately 15% were lost to follow-up. | Not reported |
| Sankaranarayanan et al.[23] | 2007 | Colposcopy and Histology | Same day | 1.20% | Not reported | Not reported | Yes | Yes | A central referral center was established at the CFCHC, Ambillikai, with facilities for treatment of detected lesions by loop electrosurgical excision procedure (LEEP) and cold knife conisation. When lesions were too extensive for cryotherapy, women were given an appointment to visit the referral center for LEEP or cold knife conisation by doctors. | Women with suspected invasive cancer were referred to the clinical oncology department of the CFCHC or to other cancer treatment facilities near the district for investigations, staging and treatment. | |
| Bhatla et al.[5] | 2009 | Colposcopy and Histology | Same day | Not reported | Not reported | Not reported | Yes | No | 9/37 (24.3%) women diagnosed with CIN 1 were lost to follow up | All 20 women with CIN 2+ underwent treatment. 0% lost to follow-up | |
| Gravitt et al.[24] | 2010 | Colposcopy and Histology | Referred | 44% | 38% | Women refused | Yes | No | No info provided for CIN 1 | Of the 19 women who had CIN2+, we provided LEEP for 2, hysterectomy for 9, and referral to the cancer hospital for radiation therapy for 4 women who had invasive cancer. Four women (21%) refused treatment despite several direct visits by the study gynecologist for direct counseling. | Not reported |
| Kumar et al.[10] | 2011 | Colposcopy and Histology | Same day | Not reported | Not reported | Not reported | Yes | No | Referred to tertiary care center | ||
| Deodhar et al.[25] | 2012 | Colposcopy and Histology | Same day | 0% | 3.60 % | Refusal | Yes | Unclear | No info provided for CIN 1 | Of 112, 98 received LEEP and 1 received LEEP + hysterectomy and 13 (11.6%) were lost to follow up. | Invasive cancers were referred to a tertiary hospital for further investigations and management. |
| Basu et al.[26] | 2013 | Colposcopy and Histology | Not reported | Not reported | Not reported | Not reported | Not reported | Not reported | Not reported | ||
| Shastri et al.[32] | 2013 | Colposcopy and Histology | Referred | 20.60 % | Not reported | Predictors of non-compliance: increasing age, manual labourers, illiteracy, language barriers, one time screening participation, women referred for both breast and cervical cancer | Yes | No | Compliance to treatment for pre-invasive cancer is 80.67% | Compliance to treatment for invasive cancer was 85.93% | |
| Ghosh et al.[31] | 2014 | Colposcopy and Histology | Same day | 0% | 3.10% | Not reported | Not reported | Not reported | Not reported | ||
| Jeronimo et al.[27] | 2014 | Colposcopy and Histology | Referred | Not reported | Not reported | Not reported | Yes | No | Not reported | Women with moderate to severe CIN (CIN2+) were treated with cryotherapy as eligible and/or referred for further management. | Not reported |
| Satyanarayana et al.[28] | 2014 | Colposcopy and Histology | Referred | 70.90 % | Not reported | Maybe referral | Yes | No | Referred to tertiary care center | ||
| Basu et al.[29] | 2015 | Colposcopy and Histology | Same day | 0% | 2.60% | Refusal | Yes | No | CIN1 = 1880 were advised for yearly f/ups | The total patients diagnosed with CIN 2 + were 230 of which 37 (16.1%) were loss to follow up at CNCI. | Of the 48 women diagnosed with invasive cancer, 6 (12.5%) were loss to follow up |
| Poli et al.[30] | 2015 | Colposcopy and Histology | Same day | Not reported | Not reported | Not reported | Yes | No (only first two years) | Cryotherapy where eligible | Women requiring treatment for HSIL other than cryotherapy or with invasive cancer were referred to a higher center for appropriate treatment. | Not reported |