Y Adam1, C J van Gelderen, K Newell. 1. Department of Obstetrics and Gynaecology, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Johannesburg. yasminadam@gmail.com
Abstract
OBJECTIVES: An audit was undertaken of a 'colposcopy and treatment' clinic between April 2003 and December 2006, to determine: (i) the frequency of overtreatment with Papanicolaou smear on its own, colposcopy on its own or a combination of the two methods; (ii) differences in overtreatment between patients who are HIV positive and those who are HIV negative; and (iii) the short-term complications of Lletz (large loop excision of the transformation zone) at this clinic. DESIGN: An analysis of the data from the colposcopy clinic database of patients, who were referred according to national guidelines. SETTING: Patients who are referred to Chris Hani Baragwanath Hospital. RESULTS: Normal histology was found in 1.3% of patients, and cervical intraepithelial neoplasia (CIN)1 or human papillomavirus (HPV) in 8.4%. The overall complication rate was 3%. CONCLUSION: The high loss to follow-up and the low early complication rate together with an acceptable overtreatment rate make this a justifiable approach in our situation. HIV-negative women were more likely to be overtreated than HIV-positive patients(p=0.03).
OBJECTIVES: An audit was undertaken of a 'colposcopy and treatment' clinic between April 2003 and December 2006, to determine: (i) the frequency of overtreatment with Papanicolaou smear on its own, colposcopy on its own or a combination of the two methods; (ii) differences in overtreatment between patients who are HIV positive and those who are HIV negative; and (iii) the short-term complications of Lletz (large loop excision of the transformation zone) at this clinic. DESIGN: An analysis of the data from the colposcopy clinic database of patients, who were referred according to national guidelines. SETTING:Patients who are referred to Chris Hani Baragwanath Hospital. RESULTS: Normal histology was found in 1.3% of patients, and cervical intraepithelial neoplasia (CIN)1 or human papillomavirus (HPV) in 8.4%. The overall complication rate was 3%. CONCLUSION: The high loss to follow-up and the low early complication rate together with an acceptable overtreatment rate make this a justifiable approach in our situation. HIV-negative women were more likely to be overtreated than HIV-positivepatients(p=0.03).
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