Diagnosis and treatment of cervical intraepithelial neoplasia in general practice.

Abstract

To audit the first five years of a colposcopy and treatment service for cervical dysplasia established within a general practice. A cervical smear register was established to determine which women were "at risk" of dysplasia. The results of colposcopy and treatment of dysplasia were analysed. A large rural general practice with community hospital facilities in mid-Wales. 4437 Women at risk in a total practice population of 14,100. Colposcopy of women with dyskaryotic smear results, persistent inflammatory smear results, or vulval warts. Treatment of women with proved dysplasia by electrodiathermy of the cervix or cone biopsy. 138 Women with dysplasia were diagnosed over five years: 36 mild, 97 moderate or severe, and five with microinvasion. Despite a 78% smear rate of at risk women over five years, nine invasive cancers still occurred. The results of treatment are acceptable. Cervical dysplasia has become very common, the risk of a dysplasia in women aged 20-39 who had smear tests being one in 14 over five years.