'Look and Lletz/' ­ a Chris Hani Baragwanath Hospital experience

ABSTRACT

Objectives. An audit was undertaken of a 'colposcopy and treatment' clinic between April 2003 and December 2006; to determine (i) the frequency of overtreatment with Papanicolaou smear on its own; colposcopy on its own or a combination of the two methods; (ii) differences in overtreatment between patients who are HIV positive and those who are HIV negative; and (iii) the short term complications of Lletz (large loop excision of the transformation zone) at this clinic. Design. A retrospective analysis of data from the colposcopy clinic database of patients; who were referred according to national guidelines. Setting. Patients who are referred to Chris Hani Baragwanath hospital. Results. Normal histology was found in 1.3 of patients; and cervical intraepithelial neoplasia (CIN) 1 or human papillomavirus (HPV) in 8.4. The overall complication rate was 3. Conclusion. The high loss to follow-up and the low early complication rate together with an acceptable overtreatment rate make this a justifiable approach in our situation. HIVnegative women were more likely to be overtreated than HIVpositive patients (p=0.03)