Do women with glandular abnormalities require colposcopy follow-up?

PURPOSE: To determine whether cervical glandular abnormalities can be safely followed up by community cytology.

METHODS

A retrospective database review was conducted identifying women with a histological report of cervical glandular abnormalities over a three-year period.

RESULTS

Fifty women were found to have a glandular abnormality diagnosed histologically. Twenty were initially referred for colposcopy with cytological glandular abnormalities. Thirty women with cytological squamous abnormalities were later found to have cervical glandular intraepithelial neoplasia (CGIN) at histological assessment. Two women had invasive adenocarcinoma and all others with endocervical dyskaryosis or CGIN were treated using large loop excision of the transformation zone (LLETZ). At follow-up 43 women had negative cytology, one woman defaulted further appointments, one had moved out of the area, seven were successfully treated by a repeat LLETZ following incomplete excision of CGIN at the endocervix, and five had negative cytology in the community. Three women continue to have cytological/histological abnormalities with one subsequently having a hysterectomy.

CONCLUSION

Women with endocervical dyskaryosis or CGIN should be treated by LLETZ. Provided LLETZ is repeated in cases of incomplete endocervical CGIN excision cytological follow-up can take place in the community.