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

  • Srisuwan, Siriwan (Gynaecologic Oncology Unit, Department of Obstetrics and Gynaecology in HRH Princess Maha Chakri Sirindhorn Medical Center (MSMC)) ;
  • Hamontri, Suttha (Gynaecologic Oncology Unit, Department of Obstetrics and Gynaecology in HRH Princess Maha Chakri Sirindhorn Medical Center (MSMC)) ;
  • Kongsomboon, Kittipong (Department of Preventive and Social Medicine, in HRH Princess Maha Chakri Sirindhorn Medical Center (MSMC)) ;
  • Bhamarapravatana, Kornkarn (Department of Preclinical Science, Faculty of Medicine, Thammasat University) ;
  • Suwannarurk, Komsun (Gynaecologic Oncology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, Thammasat University)
  • Published : 2014.04.30

Abstract

Background: To evaluate the overtreatment rate with the see and treat approach in the management of women with abnormal cervical cytology. Materials and Methods: A retrospective review of patients with abnormal cervical 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 were analyzed to evaluate overtreatment rate, cyto-histologic correlation and related factors. Results: Average age of S&T cases was 42 years. Ninety seven percents were referred from affiliated health care providers. The study revealed 83.2% patients had HSIL or higher from cervical cytology. Correlation between HSIL and final histology was relatively low at 75% compared to other studies. Overtreatment rate was 28%. Conclusions: S&T was done in 197 patients in a tertiary care health facility with patient satisfaction. Overtreatment occurred, but the rate can be reduced with appropriate recommendations. HSIL Pap smears should be reexamined before S&T while low grade and lesser colposcopic impression groups should obtain conventional colposcopic approach for patient future reproductive benefit.

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