为了量化宫颈镜检查时间与随后宫颈癌风险之间的关联性，本研究采用了对德克萨斯、马萨诸塞和华盛顿的医疗系统中年龄在21至79岁之间的异常宫颈癌筛查结果患者进行的纵向分析。研究结果为出现异常结果后12个月或更长时间内的宫颈癌诊断。主要分析比较了在3个月内（91天或更短）接受宫颈镜检查的情况与在3-12个月内（92-365天）接受宫颈镜检查的情况以及在异常筛查结果后12个月内未进行宫颈镜检查的情况；事后分析比较了在12个月内（365天或更短时间内）接受宫颈镜检查的情况与在12个月内未进行宫颈镜检查的情况。通过多变量Cox比例风险回归，控制了年龄、风险状态、结果严重性和医疗系统等因素，进行了关联性评估。 17,541名患者中，53.3%的患者在3个月内接受了宫颈镜检查，22.2%的患者在3-12个月内接受了宫颈镜检查，24.6%的患者在12个月内未接受宫颈镜检查。147名患者在12个月内被诊断出患有宫颈癌，并从随后的分析中被移除。65名患者（0.4%）在异常宫颈细胞学或人乳头状瘤病毒检测结果后1年（366天或更长时间）内被诊断出患有宫颈癌。与在3个月内接受宫颈镜检查的患者相比，3-12个月内接受宫颈镜检查的患者在异常筛查结果后1年以上的宫颈癌检测风险无显著差异（风险比[HR] 1.07, 95% 置信区间[CI] 0.54-2.12），而在12个月内未接受宫颈镜检查的患者中，宫颈癌检测风险更高（HR 2.34, 95% CI 1.33-4.14）。事后分析显示，在12个月内未接受宫颈镜检查的患者中，相较于在12个月内接受宫颈镜检查的患者，宫颈癌诊断风险增加了2.29倍（95% CI 1.37-3.83）；在细胞学结果为高级别的患者中，未在12个月内接受宫颈镜检查的患者宫颈癌检测风险增加了3.12倍（95% CI 1.47-6.70）。 在异常结果后1年以上的宫颈癌风险上，接受在3个月内宫颈镜检查的患者与接受3-12个月内宫颈镜检查的患者之间无差异。未在异常结果后12个月内接受宫颈镜检查的患者与接受在12个月内宫颈镜检查的患者相比，随后宫颈癌风险更高。 版权所有©2023年美国妇产科医师学会。由Wolters Kluwer Health, Inc.出版。保留所有权利。

To quantify the association between time to colposcopy and risk of subsequent cervical cancer.A longitudinal analysis of patients aged 21-79 years with an abnormal cervical cancer test result from health care systems in Texas, Massachusetts, and Washington was performed. The outcome was a cervical cancer diagnosis 12 months or more after the abnormal result. The primary analysis compared receipt of colposcopy within 3 months (91 days or less) with receipt of colposcopy at 3-12 months (92-365 days) and no colposcopy within 12 months of the abnormal test result; post hoc analyses compared colposcopy within 12 months (365 days or less) with no colposcopy within 12 months. Associations were assessed with multivariable Cox proportional hazards regression controlling for age, risk status, result severity, and health care system.Of 17,541 patients, 53.3% of patients received colposcopy within 3 months, 22.2% received colposcopy in 3-12 months, and 24.6% had no colposcopy within 12 months. One hundred forty-seven patients were diagnosed with cervical cancer within 12 months and removed from subsequent analyses. Sixty-five patients (0.4%) were diagnosed with cervical cancer more than 1 year (366 days or more) after the abnormal Pap or human papillomavirus test result. The risk of cervical cancer detection more than 1 year after the abnormal test result was not different in patients who received colposcopy within 3-12 months (hazard ratio [HR] 1.07, 95% CI 0.54-2.12) and higher among patients with no colposcopy within 12 months (HR 2.34, 95% CI 1.33-4.14) compared with patients who had colposcopy within 3 months. Post hoc analyses showed that the risk of cervical cancer diagnosis was 2.29-fold higher among those without colposcopy within 12 months compared with those who received colposcopy within 12 months (95% CI 1.37-3.83); among patients with high-grade cytology results, the risk of cervical cancer detection among those without colposcopy within 12 months was 3.12-fold higher compared with those who received colposcopy within 12 months (95% CI 1.47-6.70).There was no difference in cervical cancer risk at more than 1 year between patients who received colposcopy within 3 months compared with those who received colposcopy within 3-12 months of an abnormal result. Patients who did not receive colposcopy within 12 months of an abnormal result had a higher risk of subsequent cervical cancer compared with those who received a colposcopy within 12 months.Copyright © 2023 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.