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Trends in Colposcopy Volume

Where Do We Go From Here?

Landers, Emily E. MD; Erickson, Britt K. MD; Bae, Sejong PhD; Huh, Warner K. MD

Journal of Lower Genital Tract Disease: October 2016 - Volume 20 - Issue 4 - p 292–295
doi: 10.1097/LGT.0000000000000258
Original Research Articles: Cervix and HPV

Objective To describe the change in colposcopy volume in light of recent guideline shifts, which target higher-risk women while limiting unnecessary procedures in low-risk women.

Methods After institutional review board approval, colposcopy clinic visits at a large-volume referral center from January 2010 to December 2015 were reviewed. All women diagnosed with abnormal cervical cytology who were referred and subsequently underwent colposcopic evaluation were included. Mean monthly and annual clinic volumes were calculated. Return visit proportions were compared using chi-square test. Negative binomial regression analysis was used to examine trends.

Results There were a total of 8722 colposcopy clinic visits between January 2010 and December 2015. Approximately 7395 visits (85%) were new patient visits, and 1327 visits (15%) were return visits. The percentage of return visits declined dramatically during the study period from 22.9% (2011) of total visits to 9.0% in 2015 (P < 0.001). Annual clinic volume ranged from 903 to 1884 with a mean monthly volume of 121.13 visits (SD, 42.1). Annual volume was highest in 2011 (n = 1884) and has since demonstrated a steady decline. In 2015, average monthly volume (75.3 visits) dropped to nearly one third of its peak 218 visits per month in July 2010.

Conclusions In a large referral clinic that adheres to guideline-based screening and management recommendations, monthly colposcopy volume has declined dramatically with a reduction by two thirds compared with peak volume in 2010.

Colposcopy volume is declining significantly after recent updates to cervical cancer screening guidelines and colposcopy practices.

1Department of Obstetrics and Gynecology, 2Division of Gynecologic Oncology, and 3Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL

Correspondence to: Warner K. Huh, MD, University of Alabama at Birmingham, 1700 6th Avenue South, Women and Infants Center, Room 10250, Birmingham, AL. E-mail:

Oral presentation and winner of the “Best Scientific Paper” award at the American Society for Colposcopy and Cervical Pathology Biennial Scientific Meeting: April 9 to 12, 2014, Scottsdale, AZ.

Funding: None.

Disclosures: Warner K. Huh serves as a member of the Merck Scientific Advisory Board.

The authors have declared they have no conflicts of interest.

IRB: Approved, Protocol X130930005.

The authors have declared they have no conflicts of interest.

Copyright © 2016 by the American Society for Colposcopy and Cervical Pathology