Quality of colposcopy and treatment: data from the national survey of Italian organised cervical screening programmes.
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.
Volante
Renza
R
OIRM S. Anna, Torino.
Giubilato
Pamela
P
Ronco
Guglielmo
G
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