PMID: 8612368Sep 1, 1995Paper

Every woman with an abnormal cervical smear should be referred for treatment: debate

Clinical Obstetrics and Gynecology
G Flannelly, H Kitchener

Abstract

No dispute exists regarding the optimal management of women with moderate or severe dyskaryosis (high grade SIL). These women should have a colposcopic assessment and biopsy. Women with borderline nuclear abnormalities should have a repeat smear and undergo colposcopy only if the abnormality persists. Low-grade abnormalities (low-grade SIL) are common, and their management is relevant. We suggest that these women be referred for an immediate colposcopic assessment for the following reasons: a. a policy of cytologic surveillance allows an opportunity for default, and these women are at an increased risk of invasive cancer. b. a significant proportion of these women will have underlying CIN grade III that should be treated. c. a minority of these women revert to cytologic normality without a recurrent dyskaryotic smear and, therefore, eventually will be referred to colposcopy. d. a policy of immediate referral to colposcopy may be financially less expensive and avoid unnecessary anxiety to the woman during the period of undergoing repeated smears.

Citations

Feb 25, 2000·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·J NuovoB K Chan
Oct 9, 1998·Obstetrics and Gynecology·J MelnikowL P Howell
Oct 26, 1999·Journal of Women's Health & Gender-based Medicine·M MeanaB Rosen
Oct 20, 2006·Journal of Lower Genital Tract Disease·H S SawJ J Hyun
Dec 27, 2005·Journal of Lower Genital Tract Disease·Elaine BentleyUNKNOWN Trial of Management of Borderline and Other Low-Grade Abnormal Smears (TOMBOLA) Group
Oct 17, 2007·Cytopathology : Official Journal of the British Society for Clinical Cytology·A S AhmedM Savvas
Mar 4, 2011·Cytopathology : Official Journal of the British Society for Clinical Cytology·L SharpUNKNOWN TOMBOLA Group
Sep 8, 2011·BJOG : an International Journal of Obstetrics and Gynaecology·M E FrederiksenM Rebolj

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