The role of colposcopy in the evaluation of the clinically suspicious cervix - abstract

ABSTRACT

Women with any of the following symptoms of postcoital or intermenstrual bleeding, heavy bloodstained vaginal discharge, contact bleeding on smear taking, or clinical suspicion of cervical cancer, were evaluated by colposcopy without a prior Papanicolaou smear. This was done in order to evaluate the role of colposcopy in the evaluation of the "Clinically suspicious cervix", as Papanicolaou smear-taking in the presence of these conditions is associated with contact bleeding or heavy inflammation, resulting in an unsatisfactory smear or unreliable reporting. The colposcopic directed biopsies in 73 affected women found one (1.4 percent) to be normal, 20 (27.4 percent) to have cervicitis, 36 (49.3 percent) to have evidence of koilocytosis or mild to moderate dysplasia and 16 (21.9 percent) to have carcinoma in situ, microinvasive carcinoma or invasive cancer. The finding of pre-neoplasia and/or koilocytosis and carcinoma in one-fifth of women with a clinically suspicious cervix reinforces the clinical significance of the symptoms of postcoital and intermenstrual bleeding, as well as the importance of inspection of the cervix in relation to the detection of cervical cancer. The benefit of direct referral for colposcopy in such patients prior to Papanicolaou smear-taking is underscored (AU)