Cervicography to triage women with borderline or mild dyskaryotic cervicalPAP smears

Objective: To evaluate six years experience using cervicography to triage w omen with borderline or mildly dyskaryotic PAP smears to either immediate c olposcopy or cytological surveillance. Method. Retrospective study of 1,436 women referred to the cervicography cl inic of the Whittington Hospital, London. Women with suspicious cervigrams were examined colposcopically and biopsied. Women with normal appearances a t cervicography were followed-up with cytology over a period of a least two years. Results: Cervicography detected 281 out of 307 women with CIN 2/3 and 215 o ut of 264 women with CIN 1. The sensitivity of cervicography to detect CIN 1, 2 or 3 in women with minor PAP smear abnormalities was 92%. The specific ity was 39% and 847 (59%) of the women were referred for colposcopy; 215 (1 5%) were lost to follow-up. Conclusions: Cervicography was a sensitive method to detect CIN in women wi th mild or borderline dyskaryosis on their PAP smears. However, the low spe cificity meant that a high proportion of the women were referred for colpos copy, and a significant proportion of women were lost to follow-up. Thus ce rvicography is not an efficient strategy fur managing women with minor PAP smears abnormalities.