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See & treat protocol for evaluation & management of cervical intraepithelial neoplasia
A Kattukaran1, A Kekre, R Jose
1Department of Obstetrics & Gynaecology, Christian Medical College & Hospital, Vellore, India.
Background & Objectives:
The incidence of cervical cancer in India remains high, largely due to ineffective screening and poor patient compliance for follow up. A one step procedure where evaluation and treatment are performed at the same sitting may be a good strategy. Therefore the present study was undertaken to evaluate the feasibility of a see and treat protocol for cervical intraepithelial neoplasia in a hospital population.
Methods:
A prospective study was carried out on 285 women with using cytology and colposcopy followed by large loop excision of the transformation zone when indicated as a one step procedure.
Results:
There was a concordance between colposcopic and cytologic diagnosis. Eighteen women underwent large loop excision. Over treatment rate was 61 per cent but 80 per cent of them occurred in the low grade squamous intraepithelial lesions. The over treatment rate in high grade lesions was 20 per cent.
Interpretation & Conclusion:
A single step see and treat protocol is a feasible management strategy for high grade squamous intraepithelial lesions. However, patient education is essential before undertaking the procedure.