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Lancet Oncol. 2005 Jan;6(1):43-50.

See-and-treat strategy for diagnosis and management of cervical squamous intraepithelial lesions.

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  • 1Section of Health Services Research, Department of Biostatistics and Applied Mathematics, University of Texas MD Anderson Cancer Center, Houston, Texas, TX 77030-4009, USA.

Erratum in

  • Lancet Oncol. 2005 Feb;6(2):67.

Abstract

In a see-and-treat protocol, patients referred for colposcopy because of an abnormal Pap smear in cervical-cancer screening can be treated by loop excision, without biopsy, during one visit to the clinic. However, overtreatment in the see-and-treat strategy has been reported to be 1.2-83.3% for low-grade squamous intraepithelial lesions (SIL) and to be 13.3-83.3% for high-grade SIL. Range of overtreatment narrowed to 4.0-23.5% for those with normal pathology and to 18.0-29.4% for those with normal or low-grade pathology when calculation of overtreatment was restricted to patients diagnosed with high-grade SIL on colposcopy and referral Pap smear. Most common treatment complications are bleeding and infection. Nonetheless, the strategy has become accepted internationally: low costs, decreased patient anxiety, and increased compliance make it appealing, especially in settings with limited health resources, and for patients at risk of not being treated in a timely manner or of not returning for a second appointment. Mathematical modelling may give information about the appropriateness and usefulness of this treatment while the results of long-term clinical trials are awaited.

PMID:
15629275
DOI:
10.1016/S1470-2045(04)01712-7
[PubMed - indexed for MEDLINE]
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