Cervical intraepithelial neoplasia and condyloma: an analysis of diagnostic accuracy of posttreatment follow-up methods.

The appropriate follow-up method of patients treated for cervical intraepithelial neoplasia and condyloma is controversial. One school of thought favors cytologic testing alone, whereas the other favors cytologic testing combined with colposcopy. We have analyzed the records of 750 patients treated for cervical intraepithelial neoplasia or condyloma or both in our Colposcopy Clinic. Cytologic testing, colposcopy, and histologic examination were done routinely at 3 to 4, 6 to 8, and 12 to 15 months after treatment of the above conditions in 750 patients. Totals of 95% and 5% of all 128 persistent lesions were detected by histologic examination at the first (3 to 4 months) and second (6 to 8 months) posttreatment visits, respectively. The combined false negative rates for both visits were 23% for cytologic testing, 8% for colposcopy, and 5% for histologic examination. False negative rates at first visits were 1.5% for colposcopy combined with cytologic testing. These observations suggest that colposcopy and, if appropriate, histologic examination significantly contribute to cytologic testing for diagnosing the majority of persistent disease during the first posttreatment visit. Cytologic testing alone seems to be sufficient for the subsequent follow-up of patients treated for cervical intraepithelial neoplasia and/or condyloma.