Description of Referrals for Colposcopy in a Hospital in Brazil

Abstract

Objective To describe the referral for colposcopy in a Hospital in Brazil and the relative frequency of patients who benefited from it, considering the correct indications for the examination and its final diagnoses. Methods A retrospective study was performed in the colposcopy service database of the Hospital Universitário de Taubaté, Taubaté, state of São Paulo, Brazil. The frequency validated in the analysis of the medical records of women referred for clinical indication or cytological alteration, attended from March 2015 to March 2017. The population selected and analyzed included 256 results that were correlated to the cytological, clinical data and the result of the colposcopy. Results Of the women referred, 45% presented out of the age of screening according to the guidelines of cervical cancer screening, 8.6% being adolescents and young adults < 25 years old, and 36.4% of the patients being ≥ 65 years old. A total of 50% of the patients had no indication of colposcopy, that is, normal cytologies, benign changes, ectopia, cervicitis, atypical squamous cells of indeterminate significance (ASC-US) and low-grade intraepithelial lesion (LSIL) without persistence and normal clinical appearance. A total of 39.84% who underwent colposcopy had high-grade lesion or cancer results, thus benefiting from the adequate referral. Conclusion Most (60.16%) of the patients referred to the colposcopy service did not benefit from the referral for results without changes, such as negative colposcopies, histologies with no cervical intraepithelial neoplasm (CIN) or only CIN 1, or were out of the age for screening. These findings therefore demonstrate a significant number of unnecessary and inadequate referrals.

Hallazgos colposcópicos según la clasificación de rio 2011 e histopatológicos en pacientes con anormalidad de células epiteliales. Mérida, Venezuela, 2020

“…Los cambios de grado 1 sugieren condiciones benignas o lesiones de bajo grado, mientras que los cambios de grado 2 son indicativos de lesiones de alto grado. Los hallazgos inespecíficos son las condiciones que pueden estar asociadas con lesiones neoplásicas pero que también se observan en condiciones benignas (Andía et al, 2018;De Carvalho et al, 2020).…”

Evaluation of Cervical High-Grade Squamous Intraepithelial Lesions-Correlated Markers as Triage Strategy for Colposcopy After Co-Testing

“…However, many studies found that although co-testing effectively improved the effectiveness of cervical cancer screening, more than 60% of patients who were referred to invasive colposcopy with HSIL are ≤CIN I for pathological results. [6][7][8][9][10][11] Therefore, better triage strategies for colposcopy should be investigated to improve the accuracy of diagnoses and reduce the referral rate of colposcopy.…”