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Low Utility in Colposcopy-directed Biopsies for Non-high Grade Cytological Abnormalities on PAP Smear

[ Vol. 16 , Issue. 1 ]

Author(s):

Eronmwon E. Gbinigie, Joshua Fogel and Maggie Tetrokalashvili*   Pages 18 - 22 ( 5 )

Abstract:


Background: Clinicians commonly perform colposcopy directed biopsies on patients with low grade squamous intraepithelial lesion (LSIL) on PAP cytology even when not consistent with clinical guidelines.

Objective: We study the association of PAP cytology screening results with cervical intra-epithelia neoplasia (CIN) 2-3 high-grade dysplasia, as confirmed by colposcopy-directed biopsy.

Methods: A retrospective study of 263 women with an abnormality on the PAP smear. Multinomial logistic regression was performed with predictors of PAP cytology screening results with the outcome variable of colposcopy-directed biopsy.

Results: High grade squamous intraepithelial lesion (HSIL) had significantly increased relative risk for CIN 2-3 (RR: 9.85, 95% CI: 1.84, 52.79, p=0.008). LSIL was not significantly associated with CIN 2-3. In the comparisons of negative with CIN-1, both HSIL and LSIL were not significantly associated with a negative biopsy.

Conclusion: HSIL is associated with cervical dysplasia of CIN 2-3 while LSIL is not associated with cervical dysplasia of CIN 2-3. We do not recommend routine biopsies in patients with LSIL cytologic abnormalities unless additional compelling factors exist.

Keywords:

human papillomavirus, cervical intraepithelial neoplasia, atypical squamous cells of the cervix, squamous intraepithelial lesions of the cervix, cytologic abnormalities, cervical dysplasia.

Affiliation:

Department of Obstetrics and Gynecology, Nassau University Medical Center, East Meadow, NY 11554, Department of Obstetrics and Gynecology, Nassau University Medical Center, East Meadow, NY 11554, Department of Obstetrics and Gynecology, Nassau University Medical Center, East Meadow, NY 11554

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