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

Author(s): Eronmwon E. Gbinigie, Joshua Fogel, Maggie Tetrokalashvili*

Journal Name: Current Women`s Health Reviews

Volume 16 , Issue 1 , 2020

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Graphical Abstract:


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.

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Article Details

VOLUME: 16
ISSUE: 1
Year: 2020
Page: [18 - 22]
Pages: 5
DOI: 10.2174/1573404815666190821093421
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