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Current Views and Practices in the Management of Low-Grade Cervical Abnormalities-Results of a British Society for Colposcopy and Cervical Pathology Study

Objective: To determine current views and practice of the management of low-grade cervical abnormalities. Materials and Methods: A questionnaire survey was distributed to all accredited colposcopists whose details were available on the British Society for Colposcopy and Cervical Pathology database. Results: Of the 1292 colposcopists contacted, 470 responded to the questionnaire. Of these respondents, 57% were obstetricians/gynecologists, 16% were nurse colposcopists, and 12% were gynecological oncologists. Most colposcopists would only advise a woman to undergo treatment of low-grade cytology (atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion) with low-grade colposcopic findings if the disease was persistent for 24 months or more. There was significant diversity in the management between colposcopists working in different medical specialties. Gynecological oncologists and nurse colposcopists were less likely to be influenced by poor compliance (p <.01) or immunosuppression (p <.01) into offering treatment earlier for low-grade disease. Also, community gynecologists were more likely to routinely offer ablative treatment of low-grade disease compared with colposcopists based on secondary care, p <.01. Conclusions: The need for conservative management with low-grade cervical abnormalities and the accurate diagnosis of disease progression seem to be well understood. The reported management of low-grade cervical abnormalities seem to follow the National Health Service Cervical Screening Programme guidelines; however, there is diversity in practice between colposcopists working in different medical specialties.