'Look and Lletz'--a Chris Hani Baragwanath Hospital experience.
OBJECTIVE
An audit was undertaken of a 'colposcopy and treatment' clinic between April 2003 and December 2006, to determine: (i) the frequency of overtreatment with Papanicolaou smear on its own, colposcopy on its own or a combination of the two methods; (ii) differences in overtreatment between patients who are HIV positive and those who are HIV negative; and (iii) the short-term complications of Lletz (large loop excision of the transformation zone) at this clinic.


METHODS
An analysis of the data from the colposcopy clinic database of patients, who were referred according to national guidelines.


METHODS
Patients who are referred to Chris Hani Baragwanath Hospital.


RESULTS
Normal histology was found in 1.3% of patients, and cervical intraepithelial neoplasia (CIN)1 or human papillomavirus (HPV) in 8.4%. The overall complication rate was 3%.


CONCLUSIONS
The high loss to follow-up and the low early complication rate together with an acceptable overtreatment rate make this a justifiable approach in our situation. HIV-negative women were more likely to be overtreated than HIV-positive patients(p=0.03).
Adam
Y
Y
Department of Obstetrics and Gynaecology, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Johannesburg. yasminadam@gmail.com
van Gelderen
C J
CJ
Newell
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D002584:Cervix Uteri / Q000473:pathology*; D003127:Colposcopy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008485:Medical Audit; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000473:pathology; D012017:Referral and Consultation; D012189:Retrospective Studies; D013019:South Africa; D002583:Uterine Cervical Neoplasms / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000473:pathology