CHAPTER 4: SCREENING FOR CERVICAL CANCER

142 Chapter 5: Diagnosis and Management of Precancer5Chapter 5: Diagnosis and Management of PrecancerFOLLOW-UP AFTER TREATMENTWomen should return for a follow-up visit 2–6 weeks after treatment. The visit shouldinclude the following:• gynaecological examination to ensure the cervix is healing well;• counselling to emphasize the need for regular follow-up;• discussion of results of histopathology (in the case of LEEP and conization).If the entire lesion was removed, the patient should return for further follow-up visits at6 and 12 months. In cases of positive margins (for precancer) after LEEP or cold knifeconization, the patient should be advised that she will need close follow-up and mightneed further treatment.Follow-up visits after 6 and 12 months should include the following:• A screening test and, if possible, colposcopy and directed biopsy of any persistentlesions.• If no abnormalities are seen on the first two follow-up visits, patients treated forCIN 1 or CIN 2 can be referred back to the screening programme.Patients treated for CIN 3 should be rescreened every year for 5 Annex 5years, and then referred back to the screening programme(see Annex 5).Flowchart precancer• If the lesion progresses or persists, re-treatment is needed.