The diagnosis, treatment and complications of cervical intraepithelial neoplasia--experience at the Royal Hospital for Women, Sydney, during the years 1972-1982.

During the 11 years 1972-1982, 770 patients with cervical intraepithelial neoplasia III (carcinoma in situ/severe dysplasia) were treated at The Royal Hospital for Women, Sydney. Of these, 592 had primary conization (Group I) and 153 had colposcopically directed biopsy and diathermy (Group II). Carcinoma in situ was diagnosed in the remaining 25 following hysterectomy for other gynaecological indications. The recurrence rates were similar in the 2 groups, but the conization group had a complication rate of 9.6% while none of the patients in group II had any significant complications. The presenting symptoms, gravidity, cytology and histopathological diagnosis were similar in the 2 groups. The conization and subsequent hysterectomy rates have decreased over the years. However, 50% of patients are still treated in this institution by cone biopsy. More conservative treatment (biopsy and diathermy) is being performed in increasing numbers of younger patients.