Cervical cancer screening in Italy: quality of colposcopy and treatment. 2009 activity

We collected data from organised Italian cervical screening programmes on: a) the correlation between colposcopic findings (according to the 1990 international classification) and histology, and (b) the treatment/management of screen-detected histologically-confirmed cervical intraepithelial neoplasia (CIN). Data routinely registered by organised programmes were obtained as aggregated tables. Of the 30,049 reported colposcopies, 40.3% were classified as normal and 19.9% as unsatisfactory. CIN2 or more severe histology was detected in 66.4% of colposcopies classified as grade 2 or higher. Of all colposcopies, the outcome of which was CIN2 or more severe histology, 41.8% were classified as grade 2 or higher. Of the 5,734 women with CIN1, 73%were recommended to have follow-up only. However, 0.8%of them had cold-knife conisation and 3.8%were treated by diathermocoagulation. Of the 3,713 women with CIN2 or CIN3, 5.1%had not yet been treated when data were collected, and no data were available for a further 15.1%. Excision by radio-frequency device was the most common treatment among these women (68.6% of those with known treatment). However 0.4% of all CIN2 and 3.6% of all CIN3 had hysterectomy. Among the 199 women with invasive carcinoma, 12% plausibly with microinvasive disease had only excisional treatment reported.