This study evaluates a “see and treat” intervention for high-grade squamous intraepithelial lesions (HSIL
) on Pap smears. This is a case control study comparing cost
-effectiveness, patient compliance, and pathology obtained from immediate colposcopy and large loop excision of the transformation zone of the uterine cervix. (LLETZ
Materials and Methods.
At our institution before the onset of the study, a chart review of 100 patients with HSIL
Pap smears was performed. This was the control group. Ninety percent of the patients' in the control group who had HSIL
on Pap eventually had LLETZ
. The next consecutive 100 women presenting to the clinic who met the same inclusion criteria underwent colposcopy and LLETZ
at the same visit and were compared with the control group. Demographics, pathology, compliance, and cost
One hundred patients were treated with one visit colposcopy/LLETZ
intervention. Histologic diagnosis of cervical intraepithelial neoplasia (CIN
) 2,3 was confirmed in 94% of patients. Two percent of the patients had CIN
1, 1% had no histologic evidence of CIN
, and 3% had microinvasive cancer to a depth of 0.5–1.5mm. Cost
analysis revealed savings of $35,000 for the institution. Patient compliance was improved with a kept appointment rate of 82%.
“See and treat” intervention for HSIL
Paps was an effective tool. Treating HSIL
Paps without a separate visit for colposcopy is a cost
-effective management. This method was more convenient for patients with only one disruption of daily schedules.