Follow-up of cervical neoplasia using colposcopy and cytology - abstract

ABSTRACT

The natural history of cervical neoplasia is still not clearly determined. One way of clarifying the issue is to follow a cervical lesion with cytology and colposcopic biopsies over a period of time. Two hundred and fifty cases - mild dysplasia (110), moderate dysplasia (74), and severe dysplasia (66) - were reviewed at intervals over a period of time varying between three and five years. Biopsies were taken only when a cytological and/or colposcopic pattern suggested progression to a more severe lesion. Progression rates were follows mild dysplasia - 15 percent; moderate dysplasia - 32 percent; severe dysplasia - 45 percent. The regression rates were as follows mild dysplasia - 48 percent; moderate dysplasia - 32 percent; severe dysplasia - 20 percent. Fifteen patients had a hysterectomy for intraepithelial neoplasia diagnosed on colposcopic biopsy. Three of these with severe dysplasia had carcinoma-in-situ in the hysterectomy specimen. No case diagnosed as carcinoma-in-situ showed invasive cancer in the hysterectomy specimen. Twenty-seven cases underwent hysterectomy for treatment of carcinoma-in-situ diagnosed by cone biopsy and one of the hysterectomy specimens showed an invasive lesion. Twenty cases had therapeutic conization for a colposcopic diagnosis of severe dysplasia or carcinoma-in-situ. None had invasive cancer (AU)