The Effect of the 2012 ASCCP Consensus Guideline for Abnormal Cervical Cytology on Resident Colposcopy Training

The primary objective was to determine the theoretical number of colposcopies at a resident clinic if the 2012 American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines were applied. The secondary objective was to determine the actual number of colposcopies before and after the ASCCP guidelines. This was a two-part descriptive study. The first part applied the 2012 ASCCP guidelines to all pre-guideline colposcopy cases at a single resident clinic. These theoretical results were then compared to the actual number of colposcopies. The second part compared the actual number of colposcopies during the one-year time period before and after the guidelines. Chi-Square tests and Fisher's Exact tests were used to examine the association of categorical variables. Seventy-three colposcopies were performed during the pre-guideline period. After applying the 2012 ASCCP guidelines, 52.1% would not have been indicated, resulting in 35 colposcopies. The largest reductions would have occurred in patients with low grade cytologic abnormalities. Applying the new guidelines, patients 24 years and younger would have been less likely than patients ages 25 to 64 to require colposcopy (P<.001). Fifty-eight indicated colposcopies were actually performed during the post-guideline period. While there was a decrease in the number of colposcopies performed post-guidelines, the decrease was not as dramatic as expected. From a training standpoint, as indications for colposcopy decrease, fewer training opportunities are available for residents. In particular, residents will have less experience evaluating low grade cytologic abnormalities in younger women.