[Premalignant and malignant lesions of the uterine cervix--personal experience]

Cervical pathology represents the most frequent cause of mortality and morbidity in regard to female genital diseases in Serbia. The aim of this study was to establish the occurrence and grade of histopathologic lesions by examination of cervical biopsy specimens taking into consideration the patient's age and knife conization as a diagnostic-therapeutic procedure. The study included a period of 1993-1997 at the Department of Gynecology and Obstetrics of the Health Center in Sremska Mitrovica.

Criteria for biopsy were: colposcopic or naked eye evaluation of lesions and Papanicolaou smear grade III or higher. Conization was not performed in cases with: low grade squamous intra-epithelial lesion (L-SIL) with HPV (human papillomavirus) and high grade squamous intra-epithelial lesion (H-SIL) or microinvasive Ca (< 5 mm without distribution by lymph or blood). None of the patients had undergone biopsy before.

Our results show high occurrence of malignancy, mainly of invasive type. In elder patients all grades of pathologic lesions were established, whereas knife conization showed high efficacy. Although patients might be exposed to risk factors predominantly in their older age, it is evident that public knowledge is poor, while physician-patient relationship is unsatisfactory.

In accordance with reported, it can be concluded that there is a great need for public health education as well as improvement of secondary health care in the long run.