See-and-treat approach to cervical intraepithelial lesions in HRH Princess Maha Chakri Sirindhorn Medical Center.

BACKGROUND

To evaluate the overtreatment rate with the see and treat approach in the management of women with abnormal cervical cytology.

MATERIALS AND

METHODS

A retrospective review of patients with abnormal cervical cytology who underwent S and T at MSMC between January 2008 and December 2012 was conducted. Loop electrosurgical excision procedure (LEEP), histological results, cytology and colposcopic impression were analyzed to evaluate overtreatment rate, cyto-histologic correlation and related factors.

RESULTS

Average age of S and T cases was 42 years. Ninety seven percents were referred from affiliated health care providers. The study revealed 83.2% patients had HSIL or higher from cervical cytology. Correlation between HSIL and final histology was relatively low at 75% compared to other studies. Overtreatment rate was 28%.

CONCLUSIONS

S and T was done in 197 patients in a tertiary care health facility with patient satisfaction. Overtreatment occurred, but the rate can be reduced with appropriate recommendations. HSIL Pap smears should be reexamined before S and T while low grade and lesser colposcopic impression groups should obtain conventional colposcopic approach for patient future reproductive benefit.