An analysis of the outcomes of cervical cone biopsies performed in a low resource setting

Abstract

Following skills transfer to this low resource setting, we carried out a descriptive analysis of the outcomes of all cone biopsies performed for women with cervical intra-epithelial neoplasia 3 (CIN 3). We also compared two methods of cone biopsy.

All the women had follow-up smear tests at 6 and 18 months. There were no cases of CIN 3 at follow-up. 80% had normal smears at 18 months and 20% had CIN 1. Compared with knife cone biopsy, women who had an electric knife (hand-held diathermy blade) cone biopsy had a significantly smaller volume of mean blood loss (55.5mls ± 15.9 vs 153.3ml ± 40, p < 0.001).

With appropriate skills transfer, women with CIN 3 in a low resource setting can be effectively treated with conisation procedures. The diathermy knife is preferred to cold knife because of its associated low blood loss.

Keywords::

• Cone biopsy
• CIN 3
• colposcopy
• low resource setting
• skills transfer

Acknowledgements

The authors wish to acknowledge the financial support of the British Society for Colposcopy and Cervical Pathology for sponsoring the training of the first author at Barnet and Chase Farm Hospitals NHS Trust and for sponsoring the second author to University of Benin Teaching Hospital, Nigeria for transfer of skills, which strengthened the cervical cancer screening programme of the University of Benin Teaching Hospital.

Declaration of interest: The authors report no declarations of interest. The authors alone are responsible for the content and writing of the paper.