Objective: To evaluate colposcopic practice over a 12-month period in the UK, April 1993 to March 1994, to compare this with 1988, and to test penetration and acceptance of previously introduced national guidelines.
Design: A nationwide survey of colposcopy practice by postal questionnaire, including referral criteria, diagnosis and treatment, follow up, waiting times and information and counselling.
Setting: All gynaecology clinics in the United Kingdom.
Results: Returns were obtained from 215 clinics (78%), that saw an average of 434 new women per year. Seventy percent of clinics follow the current national guideline for cytological referral criteria for colposcopy. Diathermy loop excision is now by far the most popular treatment method for CIN. The majority of clinics employ both colposcopy and cytology for follow up. A total of 103 invasive cancers following treatment for CIN were reported during the 12-month period of the survey. Most clinics provide new patients with both information and counselling.
Conclusions: Colposcopy practice has undergone considerable changes in the last five years. There has been a good response to the introduction of a national guideline for referral for colposcopy. While local audits are necessary to identify improvements that need to be made to individual clinical services, this national audit has shown some trends over the past five years, has highlighted the problem of invasive cancer following treatment for CIN and has assessed the impact of a national guideline.