Management of the low grade squamous intraepithelial lesion pap smear in a cross-sectional, observational cohort

Jennie L. Yoost, Laura Goetzl, Rana Hoda, David E. Soper, Audrey Barry

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

OBJECTIVE: To evaluate the practice of delaying colposcopy until repeat cytology demonstrates persistent low grade squamous intraepithelial lesion (LSIL). STUDY DESIGN: A retrospective cross-sectional analysis was performed on patients diagnosed with LSIL in a high-risk urban population. Primary outcomes were defined as regression, persistence, progression and lost to follow-up. RESULTS: A total of 624 patients received an initial cytologic diagnosis of LSIL. Of these, 260 (42%) were lost to follow-up despite multiple contact attempts. Of the 364 patients available for full analysis, 168 (26%) regressed to negative cytology, 93 (15%) had persistent LSIL/cervical intraepithelial neoplasia (CIN) 1, and 103 (17%) progressed to high grade cervical intraepithelial neoplasia (HSID/CIN 2/3. Higher rates of LSIL regression were observed in teenagers (≤ 20) compared to women aged 21-30 or >30 (51% vs. 43% vs. 45%), although this was not statistically significant (p= 0.29). CONCLUSION: Delaying colposcopy to repeat cytology resulted in a significant loss to follow-up in a population at high risk for poor compliance. In women with LSIL over 20 years of age, immediate colposcopy is recommended when optimal patient compliance cannot be ensured. Only 25% of patients avoided eventual colposcopy by regression to normal cytology.

Original languageEnglish (US)
Pages (from-to)421-424
Number of pages4
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume54
Issue number7
StatePublished - Jul 1 2009
Externally publishedYes

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Papanicolaou Test
Colposcopy
Cervical Intraepithelial Neoplasia
Cell Biology
Lost to Follow-Up
Urban Population
Patient Compliance
Squamous Intraepithelial Lesions of the Cervix
Cross-Sectional Studies

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

Management of the low grade squamous intraepithelial lesion pap smear in a cross-sectional, observational cohort. / Yoost, Jennie L.; Goetzl, Laura; Hoda, Rana; Soper, David E.; Barry, Audrey.

In: Journal of Reproductive Medicine for the Obstetrician and Gynecologist, Vol. 54, No. 7, 01.07.2009, p. 421-424.

Research output: Contribution to journalArticle

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