Quality of colposcopy and treatment: data from the national survey of Italian organised cervical screening programmes. 2008 activity.

We collected data from organised Italian cervical screening programmes on (a) the correlation between colposcopic findings (according to the 1990 international classification) and histology, and (b) the treatment/management of screen-detected histologically confirmed cervical intraepithelial neoplasia (CIN). Data routinely registered by organised programmes were obtained as aggregated tables. Of the 25,932 reported colposcopies 38.1% were classified as normal and 20.2% as unsatisfactory. CIN2 or more severe histology was detected in 64.0% of colposcopies classified as grade 2 or higher. Of all colposcopies, the outcome of which was CIN2 or more severe histology, 41.7% were classified as grade 2 or higher. Of the 4,923 women with CIN1, 78.1% had follow-up only. However 0.8% of them had cold-knife conisation, 4.7% were treated by diathermocoagulation and 0.1% had a hysterectomy. Of the 3,788 women with CIN2 or CIN3, 3.9% had not yet been treated when data were collected and no data were available for a further 9.9%. Excision by radio-frequency device was the most common treatment among these women (66.7% of those with known treatment). However 0.7% of all CIN2 and 4.0% of all CIN3 had a hysterectomy. Among the 163 women with invasive carcinoma, 17.2% plausibly with microinvasive disease had only excisional treatment reported.