Effectiveness of see-and-treat for approaching pre-invasive lesions of uterine cervix

Revista de Saúde Pública

Aparecida Cristina Sampaio Monteiro²  Fábio Russomano²  Aldo Reis¹  Maria José De Camargo²  Susana Aidé Fialho²  Maria Aparecida Tristão¹  Thiers Soares² 

[1],Fundação Oswaldo Cruz Instituto Fernandes Figueira Departamento de GinecologiaRio de Janeiro,Brasil

关键词: Cervix Uteri;    pathology;    Colposcopy;    classification;    Cervical Intraepithelial Neoplasia;    Uterine Cervical Neoplasms;    diagnosis;    Colo do Útero;    patologia;    Colposcopia;    classificação;    Neoplasia Intra-Epitelial Cervical;    Neoplasias do Colo do Útero;    diagnóstico;    Cuello del Útero;    patología;    Colposcopía;    clasificación;    Neoplasia Intraepitelial del Cuello Uterino;    Neoplasias del Cuello Uterino;    diagnóstico;   

DOI  :  10.1590/S0034-89102009000500014

来源: SciELO

【 摘 要 】

OBJECTIVE: To compare the effectiveness between the see-and-treat (S&T) approach and the conventional one (with prior biopsy) for squamous intraepithelial lesions of uterine cervix. METHODS: A cross-sectional study was conducted with 900 nonpregnant women with cytology suggestive of high grade squamous intraepithelial lesions in the city of Rio de Janeiro, Southeastern Brazil, between 1998 and 2004. The S&T approach consists of a large loop excision of the transformation zone procedure and is recommended when cytology is suggestive of high grade squamous intraepithelial lesion, satisfactory colposcopy with abnormalities compatible with the suspected cytological results, and the lesion is limited to the ectocervix or extends up to one centimeter of the endocervical canal. A subgroup of 336 patients whose colposcopy was considered satisfactory was analyzed, and they were divided into two groups for comparison: patients treated without prior biopsy (n = 288) and patients treated after a biopsy showing high grade squamous intraepithelial lesions (n = 48). Patients who were not treated or only treated more than a year later after recruitment at the colposcopy unit were considered dropouts. RESULTS: Of patients recruited during the study period, 71 were not treated or were only treated for at least a year. The overall dropout rate was 7.9% (95% CI: 6.1;9.7). Mean time elapsed between patient recruitment and treatment was 17.5 days in the S&T group and 102.5 days in the prior biopsy group. Dropout rates were 1.4% (95% CI: 0.04;2.7) and 5.% (95% CI: 0;12.3), respectively (p=0.07). The proportion of overtreated cases (negative histology) in the S&T group was 2.0% (95% CI: 0.4;3.6). CONCLUSIONS: The difference in the mean time elapsed between patient recruitment and treatment indicates that S&T is a time-saving approach The proportion of negative cases from using the S&T approach can be regarded as low.

【 授权许可】

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