THE VALUE OF CYTOLOGY AND COLPOSCOPY IN THE FOLLOW-UP OF CERVICAL INTRAEPITHELIAL NEOPLASIA AFTER TREATMENT BY LASER EXCISION

Objective To determine the value of colposcopic assessment in the follow up of cervical intraepithelial neoplasia (CIN) treated by laser excision. Design Retrospective analysis of case records of women with CIN treated by laser excision over the period 1986 to 1990. Setting A colposcopy clinic in a district general hospital. Subjects Five hundred-forty consecutive patients with either CIN or microinvasion diagnosed on laser excision specimens. Results Of 452 patients followed up for 10 months, 14 were diagnosed as having persistent CIN. Eleven of these were detected at the first follow up visit at four months using both colposcopic and cytological assessment. Elimination of colposcopic assessment in follow up would have reduced the number detected to five patients. Conclusion For patients undergoing laser excision for CIN involving the endocervical canal, a normal initial, post-treatment colposcopy is necessary before surveillance may be reduced to cytology alone.