Incidences of Cervical Intraepithelial Neoplasia 2-3 or Cancer Pathologic Diagnoses in Patients with a High Grade Squamous Intraepithelial Lesion Pap Smear Attending a Colposcopy Clinic at Srinagarind Hospital

The aim of this study was to evaluate the outcomes of women with high-grade squamous intraepitheliallesion (HSIL) smears who had undergone the “see and treat” approach compared to those who underwent aconventional approach. The records of women with HSIL smears undergoing colposcopy at Srinagarind Hospitalwere reviewed. In those undergoing the conventional approach, the final histological diagnosis was made on themost severe histological results obtained after initial colposcopy. In the “see and treat” group, the final histologicaldiagnosis was made on the examination of LEEP specimens obtained after initial colposcopy. Overtreatment inthe see and treat group was defined as the LEEP specimens containing cervical intraepithelial neoplasia (CIN) 1or less. During the study period, 302 women with HSIL underwent colposcopy. Twenty (6.6%) were nulliparous.One hundred and ninety-four (64.2%) underwent conventional management while the remaining 108 (35.8%)received the see and treat management. The prevalence of underlying high-grade lesions in women undergoingthe conventional approach was significantly higher than that observed among women undergoing the see andtreat approach (89.2% and 47.2%, respectively, P<0.001). The overtreatment rate in the see and treat group was52.8%. Multivariate analysis revealed that only parity status was a statistically significant factor for predictingthe overtreatment after undergoing the see and treat approach. In conclusion, the overtreatment rate amongwomen undergoing see and treat in this study is notably high and therefore this approach should not be routinelypracticed.