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The clinically suspicious cervix--how often is it cancer?
Dimitrios S Milingos1, Vanessa N Harry, Margaret E Cruickshank
1Department of Obstetrics and Gynecology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, UK. dmiligk@doctors.org.uk
Journal of Lower Genital Tract Disease
|July 2, 2010
Summary
Most women referred for a clinically suspicious cervix do not have cancer. These patients are better assessed in general gynecology clinics, reserving colposcopy for confirmed cases.
Area of Science:
- Gynecologic Oncology
- Cervical Pathology
- Colposcopy Referral Criteria
Background:
- A 'clinically suspicious cervix' is a common referral reason to colposcopy services.
- The diagnostic yield of colposcopy for this indication is not well-established.
Purpose of the Study:
- To evaluate the diagnostic outcomes for women referred to colposcopy with a clinically suspicious cervix.
Main Methods:
- Prospective cohort study involving women referred to a dedicated colposcopy clinic.
- Review of referral letters and subsequent case note review for data collection.
- Inclusion criteria: referral letter stating 'clinically suspicious cervix'.
Main Results:
- 104 women were identified; 95 attended colposcopy.
- 76% (80%) had normal or benign cervical pathology.
- 15% (16%) had cervical intraepithelial neoplasia; 4% (4%) had invasive cancer.
Conclusions:
- Colposcopy is overutilized for women with a clinically suspicious cervix.
- Suggests assessment in general gynecology clinics to improve resource allocation.
- Allows focused colposcopy referrals for confirmed malignancies or high-grade lesions.
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