Impact of introduction of colposcopy to a district general hospital.

During the first 18 months of operation of a new colposcopy clinic, established in a district general hospital, 608 women were seen. Most (568 (93.0%] were referred from within the local district, on the whole by their general practitioner. In 466 cases a repeat cervical smear was taken, and all women underwent colposcopic examination together with directed punch biopsy of any abnormal area. Positive cytology was seen in 356 women, but 85 (23.9%) of these were found to have no histological evidence of malignancy or premalignancy and were consequently discharged from the clinic. Cervical intraepithelial neoplasia was confirmed histologically in 379 women, of whom 259 were under 35 and 175 nulliparous. As a result of the use of colposcopy and local destructive methods of treatment only 42 patients (11.1%) were required to undergo cone biopsy. The initial overall incidence of success in the treatment of cervical intraepithelial neoplasia was 86.2% for cone biopsy, 88.5% for diathermy, and 81.1% for laser ablative treatment. Colposcopy has an important role in the management of cervical neoplasia in the district general hospital.