Macroscopic prediction of cervical dysplasia at colposcopy for see-and-treat patient selection: a systematic review.

In 30 seconds

This systematic review evaluated colposcopy guidelines to identify macroscopic indicators for selecting patients for see-and-treat management of cervical dysplasia. The review included six guidelines and 39 primary studies, revealing overtreatment rates of 6.3-56.5% for CIN2 and 9.9-72.5% for CIN3, alongside a 7.6% undertreatment rate in women with normal colposcopic impressions but CIN3 or cervical cancer on histopathology.

Key findings

• Overtreatment rates for CIN2 ranged from 6.3% to 56.5%, and for CIN3 from 9.9% to 72.5%.
• 7.6% of women with normal colposcopic impressions had CIN3 or cervical cancer on histopathology.
• Eight colposcopic indicators were consistently mentioned across guidelines.

Why it matters

Accurate colposcopic diagnosis is crucial in see-and-treat protocols to prevent both overtreatment and undertreatment of cervical dysplasia, which can significantly impact patient outcomes.