TRIAGE OF PATIENTS WITH ABNORMAL CERVICAL SMEARS IN THE ABSENCE OF COLPOSCOPY

In a group of 246 patients with dyskaryotic cervical smears, 144 had 4 -quadrant punch biopsies (4Q), while 102 had Lugol's iodine applied to the cervix before punch biopsies were taken from abnormally stained a reas (ISD) to determine whether the latter will improve the chances of taking biopsies from areas of cervical intraepithelial neoplasia (CIN ). In the ISD group, 66 (64.7%) of the patients had histological confi rmation of CIN compared to 56 (38.9%) of those in the 4Q group. Follow -up smears in patients with benign histological findings revealed dysk aryosis in 54.7% and 25% in the 4Q and ISD groups respectively, which is suggestive of a higher false-negative rate in the 4Q group. It is s uggested that where facilities for colposcopically-directed biopsy of the cervix is unavailable, patients with abnormal smears should have L ugol's iodine applied before punch cervical biopsies are taken.