Comparison of immediate and deferred colposcopy in a cervical screening program.
OBJECTIVE
To evaluate the effect of delaying colposcopy in women with negative Papanicolaou smears and positive speculoscopy results.


METHODS
This was a prospective study of asymptomatic women ages 13-60 years, regularly scheduled for pelvic examinations. All women had Papanicolaou smears and magnified visual examinations with speculoscopy. Women with negative Papanicolaou smears and positive speculoscopy results were quasirandomized to immediate or deferred colposcopy groups.


RESULTS
A total of 800 women completed all phases of the study, 124 of whom had negative Papanicolaou smears and positive speculoscopy results. Among 57 women who had immediate colposcopies, 64.9% had histologic evidence of neoplasia. Sixty-seven women had their scheduled colposcopies deferred for 6 months. During this period, 21% (14) were lost to follow-up and 29% (13) of those evaluated converted from speculoscopy positive to speculoscopy negative. Among the 32 (71%) women who remained speculoscopy positive, 90% were found to have histologic evidence of neoplasia on colposcopic biopsy.


CONCLUSIONS
In women with normal Papanicolaou smears and positive speculoscopy results, the diagnostic yield can be improved by deferring colposcopy for 6 months. Deferral should be considered only for women who are reliable for follow-up.
Parham
G P
GP
Division of Gynecologic Oncology, University of Arkansas for Medical Science, Little Rock 72205-7199, USA. parhamgroesbeckp@exchange.uams.edu
Andrews
N R
NR
Lee
M L
ML
D000293:Adolescent; D000328:Adult; D003127:Colposcopy; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D065006:Papanicolaou Test; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears