Internet survey of colposcopy practices

Our aim was to use electronic mail to survey health care providers about practice patterns involving atypical Papanicolaou smears.

A six-item questionnaire evaluating demographics and practice patterns was distributed on two Internet electronic mail forums: OB-GYN-L and GYN-DOCS. There were approximately 340 eligible participants.

A total of 88 (26%) completed surveys were received. The percentage of respondents to the survey who would refer patients for colposcopy was 42% for findings of atypical squamous cells of undetermined significance, unqualified (ASCUS-unqualified), 92% for findings of ASCUS-favoring neoplastic change, 18% for ASCUS-favoring reactive change, and 95% for low-grade squamous intraepithelial lesions (LGSILs). With the exception of ASCUS-favoring neoplastic change as compared to LGSILs, each category was found to be statistically different from the others (p < .001) in colposcopy practice.

This survey of practice patterns suggests that subdividing ASCUS into types favoring either reactive or neoplastic changes has been adopted clinically. LGSIL and ASCUS-favoring neoplastic change are triaged to colposcopy, whereas findings of ASCUS-favoring reactive changes are followed by colposcopy. Surveys conducted via electronic mail may have lower response rates than postal surveys.