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.