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SAMJ: South African Medical Journal

On-line version ISSN 2078-5135

Abstract

ADAM, Y; VAN GELDEREN, C J  and  NEWELL, K. 'Look and Lletz' - a Chris Hani Baragwanath Hospital experience. SAMJ, S. Afr. med. j. [online]. 2008, vol.98, n.2, pp. 119-122. ISSN 2078-5135.

OBJECTIVES: An audit was undertaken of a 'colposcopy and treatment' clinic between April 2003 and December 2006, to determine: (i) the frequency of overtreatment with Papanicolaou smear on its own, colposcopy on its own or a combination of the two methods; (ii) differences in overtreatment between patients who are HIV positive and those who are HIV negative; and (iii) the short-term complications of Lletz (large loop excision of the transformation zone) at this clinic. DESIGN: A retrospective analysis of data from the colposcopy clinic database of patients, who were referred according to national guidelines. SETTING: Patients who are referred to Chris Hani Baragwanath Hospital. REULTS: Normal histology was found in 1.3% of patients, and cervical intraepithelial neoplasia (CIN) 1 or human papillomavirus (HPV) in 8.4%. The overall complication rate was 3%. CONCLUSION: The high loss to follow-up and the low early complication rate together with an acceptable overtreatment rate make this a justifiable approach in our situation. HIV-negative women were more likely to be overtreated than HIV-positive patients (p=0.03).

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