title: Findings and outcome of teenage women referred for colposcopy at Christchurch Women's Hospital, New Zealand.
abstract: OBJECTIVE
  To determine the colposcopic findings, treatment, and follow up of 15-19 year old women referred to a large public colposcopy clinic.
  
  
  METHODS
  A retrospective review of the colposcopy database and clinical records between 1995 and 2001.
  
  
  RESULTS
  243 women or 4.7% of new referrals were aged 15-19 years. Referral smears were high-grade squamous lesions (HGSL) in 15%, and low-grade squamous lesions (LGSL) or atypical squamous cells of uncertain significance (ASCUS) in 82%. Following colposcopy, 21% had biopsy proven high-grade abnormalities but only 4% had grade 3 cervical intraepithelial neoplasia (CIN3). Of those with LGSL or ASCUS smears, 2% had biopsy-proven CIN3; and of those with HGSL smears, 14% had biopsy proven CIN3. Women underwent a mean of 4.1 colposcopy sessions; 67% underwent treatment and 26% were discharged without treatment. Sixteen percent of the women were lost to follow-up. Treatment failure occurred in 8% of those treated. For women undergoing observation, 25% were discharged after the first follow-up and less than 3% progressed to CIN3.
  
  
  CONCLUSIONS
  The rate of CIN3 in women under the age of 20 referred to colposcopy at Christchurch Women's Hospital is low. Screening teenage women results in invasive investigation and treatment without proven benefit and is not recommended. A conservative approach to the management of young women with low-grade squamous intraepithelial abnormalities is also advocated.
authors.affiliation: Department of Obstetrics and Gynaecology, Christchurch School of Medicine and Health Sciences, University of Otago, Christchurch, New Zealand. peter.sykes@chmeds.ac.nz
authors.forename: Peter
authors.initials: P
authors.lastname: Sykes
authors.forename: Dianne
authors.initials: D
authors.lastname: Harker
authors.forename: David
authors.initials: D
authors.lastname: Peddie
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002584:Cervix Uteri / Q000473:pathology; D003127:Colposcopy / Q000523:psychology; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008403:Mass Screening; D009520:New Zealand / Q000453:epidemiology; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000453:epidemiology*