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Summary
Previous studies on large loop excision of the transformation zone (LLETZ) report a high incidence of negative histology on the LLETZ specimens. Overtreatment may occur when there is a low threshold to treat at the first visit. In 1993, we performed LLETZ on 276 patients: in 97 (35 percent) the treatment was undertaken at the first visit. The diagnosis of neoplasia was not confirmed in 10 (3·7 percent) patients. Our study shows that a policy of selective ‘see and treat’ may minimise overtreatment of patients referred for colposcopy. We recommend that the negative histology rate after LLETZ is used as an index of the quality of care in colposcopy services.