Three-step approach versus see-and-treat approach in patients with cytological abnormalities

The aim of this study was to compare the results of see-and-treat procedure with the classical three-step procedure in terms of initial cytology and LEEP reports. We searched the pathology charts of patients that had LEEP were searched retrospectively and then they were divided into 2 groups according to the presence or absence of a cervical biopsy before LEEP. There were 116 patients in the study. Of the patients with ASCUS/LSIL cytology and a positive cervical biopsy 48.4% had CIN 2-3 at LEEP, in contrast only 19% of the patients without a prior cervical biopsy had CIN 2-3 at LEEP (p=0.031); there was no statistically significant difference between the 2 procedures in patients with a HSIL and ASC-H smear result (p=0.726 and p=1.0 respectively). In conclusion patients with ASC-H and HSIL cytology see-and-treat approach seems more advantageous, avoids delay in treatment, noncompliance and risk of skipping lesions at biopsy.