title: Is colposcopic evaluation necessary in all women with postcoital bleeding?
abstract: OBJECTIVE
  To evaluate what extent postcoital bleeding (PCB) is an indicator of cervical cancer (CIN2 (+)).
  
  
  METHODS
  This is a retrospective cohort study. Between 2007 and 2013, amongst all referred patients, a total of 1491 consecutive women who had both conventional cytology and cervical biopsy were enrolled in the study. Of those 237 women have PCB, according to biopsy results, subjects were divided into two groups: CIN1 (-) and CIN2 (+). Multiple logistic regressions was used to construct a model to predict the occurrence of CIN 2 (+) based on age, menopause, marriage status, smoking, PCB, HPV and cytology.
  
  
  RESULTS
  Among the all women with CIN 2 (+) colposcopy guided biopsy result, PCB was 13.1% (53/406). The relationship between biopsy results and age, parity, menopausal status, marital status, smoking, presence of PCB, HPV DNA, and cytology is statistically significant (p=0.012, p=0.001, p=0.023, 0.013, p>0.001, p=0.038, p<0.001, p<0.001, respectively). According to regression analysis only smoking, HPV (+) and abnormal cytology increase the probability of CIN2 (+); 1.687 times (p=0.018), 4.065 times (p<0.001), 5.787 times (p=0.001) respectively. Having PCB only does not indicate an increased risk of CIN2 (+).
  
  
  CONCLUSIONS
  Colposcopic examination and biopsy should be performed only in the situation where women have PCB and any of the following: smoking, positive HPV, or abnormal cytology.
authors.affiliation: Baskent University School of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Ankara, Turkey. Electronic address: cagrigulumser@yahoo.com.
authors.forename: Cagri
authors.initials: C
authors.lastname: Gulumser
authors.affiliation: Baskent University School of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Ankara, Turkey.
authors.forename: Aykut
authors.initials: A
authors.lastname: Tuncer
authors.affiliation: Baskent University School of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Ankara, Turkey.
authors.forename: Esra
authors.initials: E
authors.lastname: Kuscu
authors.affiliation: Baskent University School of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Ayhan
mesh_terms: D000328:Adult; D001706:Biopsy; D002584:Cervix Uteri / Q000473:pathology*; D003075:Coitus; D003127:Colposcopy; D005260:Female; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000175:diagnosis; D018579:Patient Selection; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000473:pathology*; D014592:Uterine Hemorrhage / Q000209:etiology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000150:complications / Q000473:pathology*
keywords: Cervical cancer; Colposcopy; Cytology; HPV; Postcoital bleeding; Smear