Outcome of women with postcoital bleeding referred for colposcopy
BACKGROUND: Most causes of postcoital bleeding (PCB) are benign but the most important cause is cervical cancer so it is important to refer women with postcoital bleeding for colposcopy. We evaluated women referred with postcoital bleeding for the prevalence of cervical abnormalities. METHOD(S): This was a retrospective study of 270 women referred with postcoital bleeding to the colposcopy clinic at the Royal Derby Hospital, Derby and those with suspected cervical abnormalities underwent colposcopy-directed cervical biopsies with or without treatment. RESULT S: Eighty-nine out of 124 women (72%) above 35 years and 108 out of 146 women (74%) below 35 years were seen for colposcopy within 4 weeks of referral. Final diagnoses confirmed cervical intraepithelial neoplasia in 35 women (13%) and high-grade cervical intraepithelial neoplasia in 10 women (3.7%). None of the women had cervical cancer and all had recently negative cervical smears. CONCLUSION(S): Although cervical cancer was not detected in the women referred for colposcopy, PCB stills presents a risk of coexisting cervical intraepithelial neoplasia so women should be referred for further assessment promptly within appropriate, improved waiting times. Most cases however will be benign with a high chance of symptom resolution providing reassurance.