THE 1993 TISH-SOCIETY-FOR-COLPOSCOPY-AND-CERVICAL-PATHOLOGY NATIONAL COORDINATING NETWORK UNITED-KINGDOM COLPOSCOPY SURVEY - COMPARISON WITH 1988 AND THE RESPONSE TO INTRODUCTION OF GUIDELINES

Objective To evaluate colposcopic practice over a 12-month period in t he UK, April 1993 to March 1994, to compare this with 1988, and to tes t penetration and acceptance of previously introduced national guideli nes. Design A nationwide survey of colposcopy,practice by postal quest ionnaire, including referral criteria, diagnosis and treatment, follow up, waiting times and information and counselling. Setting All gynaec ology clinics in the United Kingdom. Results Returns were obtained fro m 215 clinics (78%), that saw an average of 434 new women per year. Se venty percent of clinics follow the current national guideline for cyt ological referral criteria for colposcopy. Diathermy loop excision is now by far the most popular treatment method for GIN. 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 w ith both information and counselling. Conclusions Colposcopy practice has undergone considerable changes in the last five years. There has b een a good response to the introduction of a national guideline for re ferral for colposcopy. While local audits are necessary to identify im provements that need to be made to individual clinical services, this national audit has shown some trends over the past five years, has hig hlighted the problem of invasive cancer following treatment for CIN an d has assessed the impact of a national guideline.