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Colposcopy and the Conservative Management of Cervical Dysplasia and Carcinoma In Situ

From the Dysplasia Clinic, Royal Women's Hospital, Melbourne, Victoria, Australia

Abstract

This study established the importance of colposcopy in the management of the abnormal cytologic smear. With the aid of the colposcope three clinical groups could be established, each of which was managed in a specific fashion. The first group comprised 224 patients (56.4% of the series) in whom a precarcinomatous lesion was located entirely within view of the colposcope. In over 90% of this group, electrocoagulation diathermy under general anaesthesia effectively eradicated the lesion. In the second group of 162 patients (40.8% of the series) colposcopy dictated the necessity for cone biopsy as abnormal transformation zone extended out of colposcopic range. Invasive carcinoma was diagnosed from the cone specimen in 11 of these patients. Cone biopsy was therapeutically effective in 86% of the remainder. The third clinical group consisted of 11 patients (2.8% of the series) in whom early invasive carcinoma was recognized by colposcopy and the diagnosis confirmed by target biopsy.