Management guidelines for women with normal colposcopy after low grade cervical abnormalities: population study
- PMID: 10864542
- PMCID: PMC27411
- DOI: 10.1136/bmj.320.7251.1693
Management guidelines for women with normal colposcopy after low grade cervical abnormalities: population study
Abstract
Objectives: To develop an evidence based protocol for the follow up of women with low grade cervical abnormalities for whom treatment is not immediately indicated.
Design: Population outcome study.
Setting: Colposcopy clinic of an inner city teaching hospital.
Participants: 566 women with low grade cytological abnormalities who were not treated at a first visit to the colposcopy clinic, followed up for a total of 881 years.
Main outcome measures: Resolution of abnormalities, persistence of disease, and treated disease.
Results: Abnormalities resolved in 306 (54.1%) women, whereas 138 (24.4%) had persistent disease and 122 (21.5%) were subsequently treated. Colposcopic opinion, smear test results, age, smoking history, and number of pregnancies were all significantly related to outcome. Logistic regression analysis produced a model that correctly identified 70% of women whose abnormalities resolved. Only 23 of 295 women (7.8%) with a normal cervix on colposcopy and a smear without dyskaryosis at a first visit were treated by the end of the observation period.
Conclusions: Women referred with low grade cytological abnormalities who have a normal cervix on colposcopy and a negative or borderline repeat smear test result may be discharged from the colposcopy clinic. We propose a follow up protocol that could safely avoid unnecessary visits to a clinic.
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