Survey of colposcopy service provided by genito‐urinary medicine in England and Wales

Abstract

Objective To investigate the expansion of colposcopy services within genitourinary medicine (GUM) in England and Wales since 1985. Design Data collected by postal and verbal communication from 189 genitourinary medicine clinics in England and Wales in January 1990. Subjects Consultant and junior genito‐urinary physicians practising colposcopy. Main outcome measures Number of clinics providing colposcopy service; indication for colposcopy, treatment facilities available, waiting lists and training opportunities, compared with that in 1985. Results Of the 189 genito‐urinary medicine clinics contacted, 60 provided a colposcopy service and 55 of these returned completed questionnaires. There has been a 67% increase in the number of colposcopes in use and over 50% of clinics have the facilities to treat cervical pathology. Waiting lists were minimal for both examination and treatment. Both men and women are examined with the colposcope for a variety of indications. At present, 52% of career grade GUM physicians practise colposcopy compared to 24% in 1985 and 94% of senior registrars compared with 42% in 198.5 were in training or trained in colposcopy.

Cervical epithelial abnormalities are significantly associated with non‐HPV lower genital tract infection in female contacts of warts*

“…A recent survey of eolposcopy service provided by genito-urinary medicine in England and Wales found that 60 out of 189 clinics contacted provided a colposcopy service [4], Wart contacts were routinely offered colposcopy in 21 (out of 55) clinics. In the current study, cervical cytology detected only 31% of the cervical epithelial abnormalities identified at colposcopy.…”

“…In women with visible anogenital warts, the incidence of biopsy-proven koilocytosis or cervical intraepithelial neoplasia (CIN), is reported from 36 to 78% [1 -3]. The presence of external anogenital warts suggests a high risk for cervical epithelial abnormalities, and is accepted in many centres as an indication for colposcopy [4].…”

Cervical cytology and colposcopy in clinics for sexually transmitted diseases--when are they appropriate?

“…25 By 1990, 60 out of 189 clinics provided a colposcopy service. 6 In 1988 the UK National Health Service (NHS) Cervical Screening Programme of computerised call and recall for women registered with general practitioners, aged 20 to 64 years, was introduced. By March 1995, 85.7% of such women had been screened within the previous five years.7 It has been estimated that this screening has prevented thousands of cases of invasive cervical cancer.…”