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Diagnosis and treatment of cervical intraepithelial neoplasia in general practice
1Brecon Medical Group Practice.
Objective:
To audit the first five years of a colposcopy and treatment service for cervical dysplasia established within a general practice.
Design:
A cervical smear register was established to determine which women were "at risk" of dysplasia. The results of colposcopy and treatment of dysplasia were analysed.
Setting:
A large rural general practice with community hospital facilities in mid-Wales.
Patients:
4437 Women at risk in a total practice population of 14,100.
Interventions:
Colposcopy of women with dyskaryotic smear results, persistent inflammatory smear results, or vulval warts. Treatment of women with proved dysplasia by electrodiathermy of the cervix or cone biopsy.
Results:
138 Women with dysplasia were diagnosed over five years: 36 mild, 97 moderate or severe, and five with microinvasion. Despite a 78% smear rate of at risk women over five years, nine invasive cancers still occurred.
Conclusions:
The results of treatment are acceptable. Cervical dysplasia has become very common, the risk of a dysplasia in women aged 20-39 who had smear tests being one in 14 over five years.
