Management of noninvasive carcinoma of the cervix

The diagnosis of noninvasive cancer of the cervix depends on carefully performed pelvic examinations and accurate cytology. Their management is determined by the histologic picture of the lesion. Adequate biopsy material must rule out invasive cancer before conservative measures are adopted. Unless special facilities are available, a cone biopsy and D & C should be performed on all nonpregnant cases with punch biopsies showing severe dysplasia or carcinoma-in-situ. These entities are classified as CIN III according to the most modern classification. Cone biopsies and D & C should also be performed on cases with negative punch biopsies and suspicious cytology. Colposcopic diagnosis diagnosis and outpatient management of these lesions should be performed only in a clinic with the specialized facilities already outlined.