Ten-year outcomes of a one-stop colposcopy clinic: a unique service for low grade cytology

• Published in: European journal of obstetrics & gynecology and reproductive biology Vol. 169; no. 2; pp. 287 - 291
• Main Authors: Ratnavelu, Nithya, Biliatis, Ioannis, Cross, Paul A, Naik, Raj
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01-07-2013
• Subjects: Adult; Aged; Cervical intraepithelial neoplasia; Cervical Intraepithelial Neoplasia - surgery; Colposcopy; Colposcopy - statistics & numerical data; Delivery of Health Care - methods; Female; Humans; Low grade cytology; Middle Aged; Obstetrics and Gynecology; One-stop; Patient Acceptance of Health Care - statistics & numerical data; Punch biopsy; Retrospective Studies; Uterine Cervical Neoplasms - surgery; Young Adult; Low grade cytology; One-stop; Colposcopy; Cervical intraepithelial neoplasia; Punch biopsy
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2013.02.015

Abstract Objective To determine patient acceptance of treatment, and treatment default rate, at a one-stop clinic, and to establish the concordance of punch and loop histology for high grade cervical intraepithelial neoplasia (CIN) by date of excisional treatment. Study design Retrospective review of computerised data and clinic files of 2090 women with low grade cytology undergoing cervical punch biopsies between 2001 and 2011 at the colposcopy clinic, Northern Gynaecological Oncology Centre, Gateshead, UK. Punch biopsies were micro-wave processed and reported within 2 h, and women were offered immediate loop biopsy if high grade CIN was confirmed. Data were collected regarding patients’ choice for immediate or deferred treatment and default rate. Histological outcomes were compared between those undergoing immediate and deferred loop biopsies. Results Of the 360 women (17%) with high grade CIN on punch biopsy, 259 (72%) opted to have immediate loop treatment at the first visit. Of these women, 190 (73%) had high grade CIN on loop histology. Of 97 women (27%) who had deferred loop biopsy after a median of 28 days (range 7–112), 65 (67%) had high grade CIN on loop histology. The default rate at return for treatment appointments was 0% amongst all patients. Conclusion This one-stop colposcopy clinic reduces defaulting from treatment. It has proven to be a sustainable service and the majority of women, when given the choice, opt for immediate loop treatment at their first visit.