Journal of Lower Genital Tract Disease最新文献

{"title":"Recent Guidelines on Anal Cancer Screening: A Systematic Review.","authors":"Andreia Albuquerque, Filipa Fontes","doi":"10.1097/LGT.0000000000000878","DOIUrl":"10.1097/LGT.0000000000000878","url":null,"abstract":"<p><strong>Objectives: </strong>Reports have recently been published on the risk stratification of anal squamous cell carcinoma (SCC) in several populations and the benefits of treating precancerous anal lesions to reduce the risk of progression to anal SCC. These studies have led several societies to publish new recommendations for anal cancer screening. This study systematically reviews anal cancer screening recommendations across different societies and institutes published after the ANCHOR trial.</p><p><strong>Methods: </strong>The authors systematically reviewed society recommendations for anal cancer screening that have been published since July 2022.</p><p><strong>Results: </strong>This study included 6 publications: 3 societies made recommendations only for individuals living with HIV, and 3 made recommendations for other high-risk groups, such as women with vulvar cancer/high-grade squamous intraepithelial lesions (HSILs) and female transplant recipients. Four societies recommended anal cytology, with or without human papillomavirus (HPV) testing, as the first screening method. One society recommended anal cytology, HPV testing, or cotesting as possible options, while 1 suggested HPV type 16 testing. Only 1 society has made recommendations on screening discontinuation. High-resolution anoscopy was recommended during follow-ups for individuals with abnormal results, although the referral threshold varied between societies according to the screening method results. All societies that mentioned anal HSIL treatment recommended it. Four societies expanded their recommendations beyond screening and treatment to include smoking cessation and/or HPV vaccination.</p><p><strong>Conclusions: </strong>Currently, there are several recommendations for anal cancer screening that include target groups, screening methods, treatment, follow-up, and other anal SCC prevention methods.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"180-185"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying Results of Extended Genotyping to Management of Positive Cervicovaginal Human Papillomavirus Test Results: Enduring Guidelines.","authors":"L Stewart Massad, Megan A Clarke, Rebecca B Perkins, Francisco Garcia, David Chelmow, Li C Cheung, Teresa M Darragh, Didem Egemen, Thomas S Lorey, Ritu Nayar, Morgan Newman, Carolann Risley, Robert A Smith, Nicolas Wentzensen","doi":"10.1097/LGT.0000000000000865","DOIUrl":"10.1097/LGT.0000000000000865","url":null,"abstract":"<p><strong>Objective: </strong>The Enduring Consensus Cervical Cancer Screening and Management Guidelines Committee developed recommendations for the use of extended genotyping results in cervical cancer prevention programs.</p><p><strong>Methods: </strong>Risks of cervical intraepithelial neoplasia grade 3 or worse were calculated using data obtained with the Onclarity HPV Assay from large cohorts. Management recommendations were based on clinical action thresholds developed for the 2019 American Society for Colposcopy and Cervical Pathology Risk-Based Management Consensus Guidelines. Risk estimates were reviewed in relation to clinical action thresholds and used as the basis for draft recommendations. After an open comment period, recommendations were finalized and ratified through a vote by the Consensus Stakeholder Group.</p><p><strong>Results: </strong>Colposcopy is recommended after positive tests for human papillomavirus (HPV) types 16 and 18. For those positive for HPV 45, 33/58, 31, 52, 35/39/68, or 51 but negative for 16 or 18, triage with cytology or dual stain testing is recommended. When screening with primary HPV testing, for patients who test positive for HPV types 56/59/66 and no other carcinogenic types, repeat HPV testing in 1 year is recommended. When screening with cotesting, for those who test positive for HPV types 56/59/66 and no other carcinogenic types, 1-year return is recommended for negative for intraepithelial lesion or malignancy, atypical squamous cells of undetermined significance, and low-grade squamous intraepithelial lesion, and colposcopy is recommended for atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (ASC-H), atypical glandular cells, high-grade squamous intraepithelial lesion, or carcinoma. When patients without prior high-grade cytology (atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion, atypical glandular cells, high-grade squamous intraepithelial lesion, or carcinoma) or histology (cervical intraepithelial neoplasia [CIN]2, CIN3, or adenocarcinoma in situ) are being followed, use of extended genotyping results is acceptable. When high-grade cytology or histology results are present, or when patients are being followed after treatment of CIN2+, management using the 2019 guidelines is recommended.</p><p><strong>Conclusions: </strong>Human papillomavirus extended genotyping can guide clinical management in the setting of a positive HPV test result.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"134-143"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemostatic Efficacy of TachoSil in Loop Electrosurgical Excisional Procedure: A Prospective Randomized Controlled Study.","authors":"Junhwan Kim, Jeong-Yeol Park","doi":"10.1097/LGT.0000000000000867","DOIUrl":"10.1097/LGT.0000000000000867","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to evaluate the hemostatic efficacy of the fibrin sealant patch (TachoSil) after loop electrosurgical excision (LEEP) and its influence on other complications and quality of life (QoL).</p><p><strong>Materials and methods: </strong>This single-blind, prospective, randomized study involved patients undergoing LEEP with or without TachoSil (1:1) between August 2014 and August 2015 in Asan Medical Center, Korea. Primary outcome measures were bleeding duration and the frequency of additional treatment owing to vaginal bleeding within 2 weeks after LEEP. Secondary outcome measures were vaginal bleeding volume using pictorial blood loss assessment chart (PBAC) score, the amount of vaginal discharge, the frequency of external genitalia, vaginal, and cervical infections within 2 weeks after LEEP, and changes in QoL.</p><p><strong>Results: </strong>Of the 140 patients enrolled, 126 (90.0%) were successfully followed up and analyzed. The median vaginal bleeding duration and frequency of additional treatment owing to vaginal bleeding showed no significant difference in the TachoSil applied and nonapplied groups ( p = .96 and p = .61, respectively). In addition, no significant difference was also observed in vaginal bleeding volume between 2 groups ( p = .64). In subgroup analysis for patients who underwent large LEEP (the longest dimension of ≥2 cm), significant improvement was observed at physical functioning in QoL at 2-3 ( p = .03) and 6 weeks ( p = .03) after LEEP of the TachoSil applied group, compared to the nonapplied group.</p><p><strong>Conclusions: </strong>TachoSil did not demonstrate significant hemostatic efficacy after LEEP. However, TachoSil improved patient recognition on physical function in patients who underwent large LEEP.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"123-130"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Narrative Review of the Vulvar Disease Literature With Images of Women of Color.","authors":"Gabriela Ashenafi, Ulrike C Dehaeck, Nina A Madnani, Ebony C Parker-Featherstone, Natalie A Saunders, Kathryn C Welch, Arshpreet Kaur Mallhi, Hope K Haefner","doi":"10.1097/LGT.0000000000000869","DOIUrl":"10.1097/LGT.0000000000000869","url":null,"abstract":"<p><strong>Objective: </strong>To assess the existing literature on vulvar disease in women of color (WOC).</p><p><strong>Methods: </strong>A narrative review was conducted to assess the literature on vulvar disease in WOC and evaluate the presence of images in this population. The search encompassed PubMed and OVID using relevant terms related to vulvar conditions and various groups of WOC. Case reports, as well as posters were excluded. Books on this topic were searched using these two search engines and Google, as well as the Taubman Health Sciences Library at the University of Michigan. This library contains numerous books on vulvar diseases commonly used by health care providers.</p><p><strong>Results: </strong>This query identified 24 journal publications on vulvar diseases in WOC. Twenty-six books, commonly used by health care providers, were found to have been published with vulvar images of WOC. However, only 1 focused specifically on vulvar diseases in WOC.</p><p><strong>Conclusions: </strong>There is a notable scarcity of articles and books addressing vulvar conditions specifically in WOC. This gap in literature limits the understanding of how these conditions may uniquely affect this demographic population. Additional research and resources are essential to effectively represent and meet the health needs of WOC.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"201-203"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human Papillomavirus Genotype Attribution and Integration in High-Grade Vaginal Intraepithelial Neoplasia.","authors":"Yuanming Shen, Sangsang Tang, Yumei Zhou, Qiuxue Zhang, Tingting Chen, Jingnan Li, Yu Wang, Xiaoyun Wan, Weiguo Lu, Junfen Xu","doi":"10.1097/LGT.0000000000000850","DOIUrl":"10.1097/LGT.0000000000000850","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to investigate the distribution and association between human papillomavirus (HPV) genotypes and integration as well as their correlation with cervical lesions.</p><p><strong>Methods: </strong>Two hundred seven patients diagnosed with high-grade vaginal intraepithelial neoplasia (HG-VaIN) were recruited from the Women's Hospital School of Medicine Zhejiang University between 2015 and 2021 and assayed for HPV genotyping. HPV integration sequencing analysis was conducted using tissues from 53 patients with HG-VaIN and 4 patients with invasive vaginal carcinoma (IVC), along with paired cervical lesion specimens.</p><p><strong>Results: </strong>A total of 207 patients with HG-VaIN were categorized as having cervical lesions unrelated to HG-VaIN (group A, 71 patients, 34.30%) or cervical lesion-related HG-VaIN (group B, 136 patients, 65.70%). With an average follow-up of 42.19 months, 12 of 153 patients progressed to IVC and were all from group B. HPV16 infection and the presence of cervical lesions were the 2 main factors associated with disease progression, with cervical lesion coexistence being an independent factor. Compared with group A (5/20, 25%), group B (17/33, 51.52%) showed a higher rate of HPV integration, as demonstrated using HPV integration sequencing analysis, with HPV16 being the most integrated genotype (72.73%). The integration analysis of 4 patients with IVC paired with cervical lesion specimens showed that 3 of the 4 pairs exhibited the same HPV infection and integration sites, indicating a high degree of homology in HPV integration between cervical lesions and HG-VaIN-induced IVC.</p><p><strong>Conclusions: </strong>Patients with HG-VaIN associated with cervical lesions exhibited a higher risk of malignant transformation, necessitating more proactive treatment approaches.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"60-67"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing the Frequency and Severity of Clinical Signs and Architectural Changes in Vulvar Lichen Sclerosus.","authors":"Madeline Ngo, Hannah R Chang, Melissa M Mauskar","doi":"10.1097/LGT.0000000000000860","DOIUrl":"10.1097/LGT.0000000000000860","url":null,"abstract":"<p><strong>Abstract: </strong>Untreated vulvar lichen sclerosus (VLS) can have a significant negative impact on quality of life, increase the risk of neoplastic transformation, and lead to irreversible architectural changes. Early and appropriate management using ultrapotent topical steroids is crucial to alleviate symptoms and prevent long-term complications. This study aimed to characterize clinical signs and architectural changes of 364 VLS patients at a tertiary center. The majority of the patients had sought care from ≥1 provider previously, were referred by a physician, had undergone prior vulvar biopsies, and had previously tried topical steroids. The authors observed predominantly mild clinical signs alongside more frequent severe architectural changes. These findings highlight the increased need for nuanced clinical evaluation, sufficient lifelong maintenance therapy to prevent architectural changes, and improved clinical scoring systems to differentiate between active VLS disease and residual damage.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"96-98"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Distribution of Cervical Transformation Zone and Its Impact on Colposcopic Diagnosis: A Multicenter Study in China.","authors":"Zichen Ye, Xiaoli Cui, Huike Wang, Mingyang Chen, Qu Lu, Yu Jiang, Peng Xue, Youlin Qiao","doi":"10.1097/LGT.0000000000000838","DOIUrl":"10.1097/LGT.0000000000000838","url":null,"abstract":"<p><strong>Objective: </strong>The value of the transformation zone (TZ) is often overlooked in clinical settings. This study aims to assess TZ distribution, associated factors, and its impact on colposcopic diagnosis.</p><p><strong>Methods: </strong>χ 2 tests were used to analyze demographics, clinical history, and tissue samples to examine the differences in TZ distribution. Factors affecting the TZ were explored using logistic regression, and diagnostic indicators were calculated.</p><p><strong>Results: </strong>A total of 5,302 individual datasets were finally included. TZ1, TZ2, and TZ3 accounted for 31.6%, 38.5%, and 30.0%, respectively. Age is the most important factor that influences the location of the TZ. The proportion of TZ3 steadily increased with age, comprising over 55% in women over 50. The colposcopic diagnostic performance shows that high-grade squamous intraepithelial lesion or worse (HSIL+) sensitivity of TZ3 (58.1%, 95% confidence interval [CI] = 52.9-63.4) is significantly lower than that of TZ1 (69.8%, 95% CI = 65.5-74.1) and TZ2 (73.2%, 95% CI = 69.7-76.8). The HSIL+ specificity of TZ3 (96.3, 95% CI = 95.3-97.4) was higher than that of TZ1 (96.3, 95% CI = 95.2-97.3) and TZ2 (92.5, 95% CI = 91.1-93.9). The HSIL+ positive predictive value (81.3%, 95% CI = 76.4-86.2) and negative predictive value (89.3%, 95% CI = 87.6-90.9) for TZ3 are high, with no significant differences when compared with TZ1 and TZ2.</p><p><strong>Conclusions: </strong>Age predominantly influences TZ location, with TZ3 being most frequently found in women over 50. While TZ3 poses a higher risk of missed diagnosis during colposcopy, it remains clinically valuable in identifying diseased and nondiseased status. Increasing colposcopists' awareness of TZ importance is needed in clinical practice.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"6-12"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Cervical and Anal Cancer Incidence and Mortality in the United States.","authors":"Tyler R McKinnish, Lindsay M Kuroki, Julie K Schwarz, Angela L Mazul","doi":"10.1097/LGT.0000000000000859","DOIUrl":"10.1097/LGT.0000000000000859","url":null,"abstract":"<p><strong>Objectives: </strong>This article describe trends in the incidence and mortality of cervical (CC) and anal (AC) cancers by race and neighborhood socioeconomic status.</p><p><strong>Methods: </strong>The Surveillance, Epidemiology, and End Results (SEER) database was used to construct a cohort of CC and AC cases from 2006 to 2018. Incidence rates and survival were calculated by race and neighborhood socioeconomic status (nSES). Annual percent change (APC) in incidence was calculated using linear regression, and 5-year overall survival (OS) by the Kaplan-Meier method.</p><p><strong>Results: </strong>Of the cases, 33,487 CC and 16,018 AC cases were identified. Women of low nSES were nearly 4 times more likely to be diagnosed with cervical cancer than those of high nSES. Cervical cancer incidence declined marginally in all groups except for low nSES women who are White (APC 0.0). Women who are Black had lower 5-year OS than their nSES counterparts of other races (most notably for Black women of low nSES 53% vs White 63%). Similarly, the low nSES AC cohort contained nearly 3 times the number of diagnoses as the high nSES cohort. AC incidence increased most in women who are White (APC 1.8 and 2.2 for low and high nSES) and men who are Black and low nSES (APC 3.3). Five-year OS was lowest for men who are Asian American and Pacific Islander (40% and 50% for low and high nSES, respectively).</p><p><strong>Conclusions: </strong>These data suggest a strong correlation between nSES, race, and their interaction on the incidence and survival trends of HPV-related disease and highlight inconsistent effects between cervical and anal cancers.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"48-54"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the 2019 American Society of Colposcopy and Cervical Pathology Online Cervical Cancer Screening Program via 9 Large-Cohort Data of Chinese Women.","authors":"Wenkui Dai, Chunlei Guo, Qing Yang, Yi Zhang, Di Wu, Chun Wang, Jerome L Belinson, Changzhong Li, Hui Du, Xinfeng Qu, Ruifang Wu","doi":"10.1097/LGT.0000000000000852","DOIUrl":"10.1097/LGT.0000000000000852","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study is to validate the applicability and performance of the 2019 US risk-based guideline for Chinese women.</p><p><strong>Materials and methods: </strong>The authors analyzed 10,055 cases with data on human papillomavirus testing, cytology, and pathologically confirmed diagnosis (analysis-set). According to the 2019 US risk-based guideline, the authors recorded the risk value and triage recommendations for each case. Then, they assessed the concordance of the guideline triage recommendations with pathology diagnosis for the relevant case from the real-world projects.</p><p><strong>Results: </strong>Among the analysis-set, 9,495 cases with an estimated risk value were identified as analysis cohort while the remaining 560 cases were cataloged as \"special cases.\" Among the analysis cohort, 960 and 526 cases were pathologically confirmed as cervical intraepithelial neoplasia (CIN) 2+ and CIN3+, respectively. The US risk-based guideline recommended colposcopy or more aggressive interventions (Colp+) for 86.8% (833/960) of the CIN2+ and 95.8% (504/526) of the CIN3+ cases, with 87.1% sensitivity and 82.5% specificity for CIN3+ cases (AUC = 0.926, p < .0001). The US risk-based recommended no-Colp for 98.0% (6,142/6,269) of the pathologically confirmed CIN1 or benign cases. In addition, 97.3% (545/560) of the \"special cases\" cases were recommended as Colp+.</p><p><strong>Conclusions: </strong>The 2019 US risk-based guideline works well with satisfied clinical sensitivity for CIN2+ and CIN3+ and seems applicable for cervical cancer screening in China.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"31-35"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Resolution and Recurrence of Anal High-Grade Squamous Intraepithelial Lesions in People With HIV.","authors":"Joy C Zhang, Maria C Geba, Yvonne Newberry, Laura Quass-Ferdinand, Tania A Thomas, Sook Hoang","doi":"10.1097/LGT.0000000000000857","DOIUrl":"10.1097/LGT.0000000000000857","url":null,"abstract":"<p><strong>Objective: </strong>High-resolution anoscopy (HRA) with ablation of high-grade squamous intraepithelial lesions (HSIL) can prevent the development of anal cancer in people with HIV (PWH). The authors sought to characterize factors associated with successful HSIL resolution or local or metachronous recurrence.</p><p><strong>Methods: </strong>The authors conducted a retrospective study of 62 PWH who underwent HRAs from December 1, 2017, to July 1, 2022. Participants were ≥30 years old with ≥2 HRAs and ≥1 HSIL lesions. Poisson and logistic regressions were used to assess factors associated with HSIL resolution and local or metachronous recurrence of HSIL.</p><p><strong>Results: </strong>Of 62 PWH, 85.5% had resolution of at least 1 HSIL. Undergoing ≥5 HRAs with thermoablation was associated with HSIL resolution (adjusted rate ratio [aRR] = 2.82) (confidence interval [CI] = 1.55-5.15), p < .001). Tobacco use was negatively associated with resolution (aRR = 0.62 (CI = 0.43-0.90), p = .01). Of this cohort, 58.1% had HSIL recurrence. Having more HRAs (adjusted odds ratio [aOR] = 2.77 (CI = 1.27-6.06), p = .01) and female sex (aOR = 9.66 (CI = 1.14-81.85), p = .04) were associated with recurrence. Non-White race was negatively associated with recurrence (aOR = 0.12 (CI = 0.02-0.68), p = .04). This study was primarily limited by its retrospective nature and small sample size.</p><p><strong>Conclusion: </strong>This study supports the utility of HRA/ablation for HSIL treatment with >85% of participants experiencing resolution of at least 1 HSIL. The authors found that having more HRAs was associated with a higher likelihood of resolution. However, the high rate of recurrence and progression to HSIL highlights the need for continued surveillance after treatment.</p>","PeriodicalId":50160,"journal":{"name":"Journal of Lower Genital Tract Disease","volume":" ","pages":"104-109"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}