See-and-Treat Approach to Cervical Intraepithelial Lesions in HRH Princess Maha Chakri Sirindhorn Medical Center


Background: To evaluate the overtreatment rate with the see and treat approach in the management of womenwith abnormal cervical cytology. Materials and
Methods: A retrospective review of patients with abnormalcervical cytology who underwent S&T at MSMC between January 2008 and December 2012 was conducted.Loop electrosurgical excision procedure (LEEP), histological results, cytology and colposcopic impression wereanalyzed to evaluate overtreatment rate, cyto-histologic correlation and related factors.
Results: Average age ofS&T cases was 42 years. Ninety seven percents were referred from affiliated health care providers. The studyrevealed 83.2% patients had HSIL or higher from cervical cytology. Correlation between HSIL and final histologywas relatively low at 75% compared to other studies. Overtreatment rate was 28%.
Conclusions: S&T was donein 197 patients in a tertiary care health facility with patient satisfaction. Overtreatment occurred, but the ratecan be reduced with appropriate recommendations. HSIL Pap smears should be reexamined before S&T whilelow grade and lesser colposcopic impression groups should obtain conventional colposcopic approach for patientfuture reproductive benefit.