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J Obstet Gynaecol. 2009 Jul;29(5):430-3. doi: 10.1080/01443610902903094.

An audit of standards of the 'see and treat' approach in women with a high-grade squamous intraepithelial lesion on Pap smears.

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Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.


This study was undertaken to audit the performances of the 'see and treat' approach in women with a high-grade squamous intraepithelial lesion (HSIL) cytology at Chiang Mai University Hospital using selective criteria from the National Health Service Cervical Screening Programme (NHSCSP) 2004 guidelines. Women with a HSIL smear, who had undergone colposcopy and immediate loop electrosurgical excision procedure (LEEP) during June 2006 and September 2008, were reviewed. The standard measurement was determined by the following criteria: (1) the proportion of women treated at the first visit who have evidence of cervical intraepithelial neoplasia (CIN) on histology to be >90%; (2) the primary haemorrhage must be <5%; (3) the proportion of patients admitted as inpatients owing to treatment complication to be <2%. Of 247 women in this study, the histopathological results were as follows: CIN II-III, 188 (76.1%); cancer, 31 (12.6%); adenocarcinoma in situ, 5 (2.0%); CIN I, 5 (2.0%); and no CIN, 18 (7.3%). The prevalence of CIN I or higher was 92.7%. Primary haemorrhage was observed in 13 (5.3%) women. Four (1.6%) women were admitted as inpatients because of LEEP-related complications. In conclusion, the 'see and treat' approach in our institute has acceptable overtreatment and complication rates.

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