The impact of a multidisciplinary conference in the management of cervical cytological and histological abnormalities: a university hospital experience.
OBJECTIVE
This study evaluates the impact of a cytology-colposcopy correlation conference (CCCC) on the management of preinvasive cervical lesions in a university hospital.


METHODS
This is a retrospective analysis of 130 consecutive cases from the colposcopy clinic at our University Health Center that were presented in the CCCC during a period of 1 year (November 2006 to October 2007). Variables examined to assess the usefulness of CCCC included the actual number of times there was a recorded change in the diagnosis or management recommendation secondary to presentation in the conference. The algorithms from the 2001 American Society of Colposcopy and Cervical Pathology consensus guidelines for the management of cytologic and histologic abnormalities were used to identify the patients in whom the conference recommendations were a deviation from the standard society recommendations.


RESULTS
The diagnosis was changed on review of the original cytology or biopsy 24 times (13%), downgraded 13 times (7%), and upgraded 11 times (6%). The conference recommendations were a modification of the standard 2001 American Society of Colposcopy and Cervical Pathology guidelines 38 times (21%) in 34 patients. The most common triage change was the recommendation for observation of unexplained high-grade cytology with negative or lower-grade biopsy (73%), followed by observation of high-grade lesion on biopsy (27%). This recommendation, while an option in the 2006 guidelines, was not given as a choice in the 2001 guidelines.


CONCLUSIONS
The CCCC at our institution provided significant input into the management of patients with preinvasive cervical lesions, anticipating some of the changes made in the 2006 guidelines.
Garg
Gunjal
G
Department of Obstetrics and Gynecology, Detroit Medical Center, Wayne State University, Detroit, MI, USA. gunjalgarg@yahoo.com
Christensen
Carl
C
Bandyopadhyay
Sudeshna
S
Husain
Mujtaba
M
D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000166:cytology* / Q000473:pathology*; D003113:Colonoscopy; D003376:Counseling / Q000379:methods*; D005260:Female; D006651:Histocytochemistry; D006785:Hospitals, University; D006801:Humans; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control*; D055815:Young Adult