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Management of Microinvasive Cervical Cancer: A British Society for Colposcopy and Cervical Pathology Audit

Cairns, Mary MBChB1; Tidy, John MD2; Cruickshank, Margaret E. MD1

Journal of Lower Genital Tract Disease: October 2012 - Volume 16 - Issue 4 - p 403–408
doi: 10.1097/LGT.0b013e3182454ab4
Original Articles

The incidence of microinvasive cervical cancers seems to be increasing as a result of screening. However, there is little national or international guidance on best management or follow-up of women treated with conservation of the cervix.

Objective: The study aimed to assess the current management and follow-up of women with stage IA cervical cancer, according to the International Federation of Gynecology and Obstetrics, within the United Kingdom.

Design/Setting: This study is a multicenter national audit of a clinical practice in the United Kingdom.

Materials and Methods: A structured questionnaire was sent and returned electronically to all lead colposcopists in the United Kingdom on the management and follow-up of women with stage IA cervical cancer according to the International Federation of Gynecology and Obstetrics. The study was approved by the British Society for Colposcopy and Cervical Pathology.

Results: Of the 210 lead colposcopists, 110 (52%) responded. All reported that women with stage IA cervical cancer are discussed at a gynecologic multidisciplinary team meeting. Women who managed conservatively with their cervix in situ are followed up for at least 5 years. There is a wide variation in clinical management of cases with lymphovascular space involvement (LVSI) and depth of invasion greater than 3 mm (stage IA2).

Conclusions: The pattern and practice of follow-up for stage IA cervical cancer is highly variable. The development of national guidance should be considered.

1Department of Gynaecological Oncology, Aberdeen Royal Infirmary, Scotland; and 2Department of Gynaecological Oncology, Royal Hallamshire Hospital, Glossop RoadSheffield, Yorkshire, United Kingdom

Reprint requests to: Mary Cairns, MBChB, Department of Gynaecological Oncology, Aberdeen Royal Infirmary, AB25 2ZA, Scotland, United Kingdom. E-mail: marycairns@nhs.net

The authors have no conflicts of interest.

Ethical approval was not required for this study.

The authors are grateful for the support of the British Society for Colposcopy and Cervical Pathology.

©2012The American Society for Colposcopy and Cervical Pathology