Management of microinvasive cervical cancer: a British Society for Colposcopy and Cervical Pathology audit.

ABSTRACT

UNLABELLED The incidence of microinvasive cervical cancers seems to be increasing as a result of screening. However, there is little national or international guidance on best management or follow-up of women treated with conservation of the cervix. OBJECTIVE: The study aimed to assess the current management and follow-up of women with stage IA cervical cancer, according to the International Federation of Gynecology and Obstetrics, within the United Kingdom. DESIGN/SETTING: This study is a multicenter national audit of a clinical practice in the United Kingdom. MATERIALS AND METHODS: A structured questionnaire was sent and returned electronically to all lead colposcopists in the United Kingdom on the management and follow-up of women with stage IA cervical cancer according to the International Federation of Gynecology and Obstetrics. The study was approved by the British Society for Colposcopy and Cervical Pathology. RESULTS: Of the 210 lead colposcopists, 110 (52%) responded. All reported that women with stage IA cervical cancer are discussed at a gynecologic multidisciplinary team meeting. Women who managed conservatively with their cervix in situ are followed up for at least 5 years. There is a wide variation in clinical management of cases with lymphovascular space involvement (LVSI) and depth of invasion greater than 3 mm (stage IA2). CONCLUSIONS: The pattern and practice of follow-up for stage IA cervical cancer is highly variable. The development of national guidance should be considered.