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 registered by organised programmes was provided as aggregated tables. We obtained data on colpo-histological correlation from 63 programmes. Of the 14,745 reported colposcopies 38.9% were classified as normal and 19.6% as unsatisfactory. CIN1 or more severe histology was detected in 2,664/4,877 (54.6%) colposcopies classified as grade 1. CIN2 or more severe histology was detected in 865/1,239 (69.8%) colposcopies classified as grade 2 or higher. Of all colposcopies during which a CIN2 or more severe histology was detected, 40.3% had a colposcopy classified as grade 2 or higher. We obtained data on treatment from 82 programmes. Of the 2,903 women with CIN1, 69.8% had follow-up only. However 25 (0.9%) of them had cold-knife conisation, 212 (7.3%) were treated by diathermocoagulation and 17 (0.6%) had hysterectomy. Of the 2,568 women with CIN2 or CIN3, 4.9% had not yet been treated when data was collected and no data was available for a further 7.5%. Excision by radio-frequency device was the most common treatment among these women (60. 6% of those with known treatment). However, 1.5 % of all CIN2 and 5.5 % of all CIN3 had hysterectomy. Among the 140 women with invasive carcinoma 17.8%, plausibly with microinvasive disease, had excisional treatment only reported.
authors.affiliation: OIRM S. 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: D001706:Biopsy; D003127:Colposcopy / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008403:Mass Screening / Q000379:methods*; D016730:Program Development; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy