[How are excisional therapies for CIN performed in France? A national audit]. / Comment les traitements d'exérèse des CIN sont-ils réalisés en France ? Une enquête nationale.

ABSTRACT

OBJECTIVES: Evaluate how excisional therapies are performed in France and if colposcopy is used for the guidance of excision. MATERIALS AND METHODS: A national survey was performed among French gynecologists using an anonymous online questionnaire. RESULTS: A total of 555 (14.9%) gynecologists participated to the survey, only answers from the 396 (71.3%) who answered practicing excisional therapies for CIN were considered. LLETZ was the most common excisional technique employed (84.9%). Among respondents, 275 (69.3%) answered not using colposcopy at the time of excision, 67 (16.9%) answered performing excisions under naked eye vision immediately after they had performed a colposcopic examination and 52 (13.8%) under direct colposcopic vision. Although initial colposcopic training did not influence the probability to use colposcopy at the time of excision, the probability of performing excisions immediately after a colposcopic examination or under direct colposcopic vision was significantly increased by the monthly practice of 30 or more colposcopic examinations (AOR 3.34; 95%CI 1.54-7.26 and AOR 2.16; 95%CI 1.08-4.34, respectively) and by the monthly practice of 5 or more excisional therapies (AOR 3.06; 95%CI 1.42-6.56 and AOR 3.03; 95% 1.54-5.96, respectively). CONCLUSION: Only a minority of French gynecologists uses colposcopy for the guidance of excisional therapies for CIN. Such practice seems to be influenced by the number of colposcopic examinations and of excisions they perform in a month.