Management of Microinvasive Cervical Cancer: A British Society for Colposcopy and Cervical Pathology Audit

The incidence of microinvasive cervical cancers seems to be increasing as a result of screening. However, there is little national or international guidance on best management or follow-up of women treated with conservation of the cervix. Objective. The study aimed to assess the current management and follow-up of women with stage IA cervical cancer, according to the International Federation of Gynecology and Obstetrics, within the United Kingdom. Design/Setting. This study is a multicenter national audit of a clinical practice in the United Kingdom. Materials and Methods. A structured questionnaire was sent and returned electronically to all lead colposcopists in the United Kingdom on the management and follow-up of women with stage IA cervical cancer according to the International Federation of Gynecology and Obstetrics. The study was approved by the British Society for Colposcopy and Cervical Pathology. Results. Of the 210 lead colposcopists, 110 (52%) responded. All reported that women with stage IA cervical cancer are discussed at a gynecologic multidisciplinary team meeting. Women who managed conservatively with their cervix in situ are followed up for at least 5 years. There is a wide variation in clinical management of cases with lymphovascular space involvement (LVSI) and depth of invasion greater than 3 mm (stage IA2). Conclusions. The pattern and practice of follow-up for stage IA cervical cancer is highly variable. The development of national guidance should be considered.