Trends in Colposcopy Volume: Where Do We Go From Here?

Area of Science:

• Gynecology
• Public Health
• Oncology

Background:

• Recent shifts in cervical cancer screening guidelines aim to optimize colposcopy utilization.
• Guidelines now prioritize higher-risk individuals while reducing procedures for low-risk cases.

Purpose of the Study:

• To analyze trends in colposcopy clinic volume.
• To evaluate the impact of updated guidelines on colposcopy utilization at a large referral center.

Main Methods:

• Retrospective review of colposcopy clinic visits from January 2010 to December 2015.
• Calculation of mean monthly and annual clinic volumes.
• Statistical analysis of return visit proportions and volume trends using chi-square and negative binomial regression.

Main Results:

• Total colposcopy visits were 8722, with 85% new and 15% return patients.
• The proportion of return visits decreased from 22.9% in 2011 to 9.0% in 2015 (P < 0.001).
• Annual clinic volume declined steadily after peaking in 2011, with 2015 monthly volumes reduced by two-thirds compared to peak 2010 levels.

Conclusions:

• Adherence to guideline-based screening and management recommendations resulted in a substantial decrease in colposcopy volume.
• The findings indicate successful implementation of guidelines targeting colposcopy resources to higher-risk women.