title: Quality of colposcopy and treatment: data from the national survey of Italian organised cervical screening programmes.
abstract: We collected from Italian organised cervical screening programmes data (a) on the correlation between colposcopic findings (according to the 1990 international classification) and histology and (b) on the treatment/management of screen-detected histologically confirmed cervical intraepithelial neoplasia (CIN). Data routinely recorded by organised programmes was provided as aggregated tables. We obtained data on colpo-histological correlation from 41 programmes. Of the 16,292 reported colposcopies, 43% were classified as normal and 23 % as unsatisfactory. CINI or more severe histology was detected in 2278/4449 (51%) of colposcopies classified as grade 1. CIN2 or more severe histology was detected in 651/1033 (63%) ofcolposcopies classified as grade 2 or higher. Ofall colposcopies that found CIN2 or more severe histology, 41% had a colposcopy classified as grade 2 or higher. We obtained data on treatment from 71 programmes. Of the 2,895 women with CINI, 73.4% had follow-up only, 14 (0.5%) of them had cold-knife conisation, 170 (5.9%) were treated by diathermocoagulation and 4 (0.1%) had hysterectomy. Of the 1972 women with CIN2 or CIN3, 4.8% had not yet been treated when data were collected and no data was available for a further 12.9%. Excision by radio-frequency device was the most common treatment among these women (58.7% of those with known treatment). However, 0.8% of women with CIN2 and 4.2% of women with CIN3 had hysterectomy. Of the 76 women with invasive carcinoma, 19.8%, plausibly with microinvasive disease, had excisional treatment only reported.
authors.affiliation: Azienda Sanitaria Ospedaliera OIRM Sant'Anna, Torino.
authors.forename: Renza
authors.initials: R
authors.lastname: Volante
authors.forename: Pamela
authors.initials: P
authors.lastname: Giubilato
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Ronco
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D003127:Colposcopy / Q000706:statistics & numerical data*; D019092:Conization / Q000706:statistics & numerical data; D003452:Cryosurgery / Q000706:statistics & numerical data; D004564:Electrocoagulation / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D007558:Italy / Q000453:epidemiology; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D015397:Program Evaluation; D000078702:Radiofrequency Therapy; D012720:Severity of Illness Index; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery