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Several areas were found to be deficient (35% or less answered correctly) in the participating faculty, residents, or both, and these deficiencies were as follows: (1) management of postmenopausal patients with LGSIL, (2) management of patients with AGC-NOS, (3) management of patients with ASCUS and (4) timing of screening discontinuation.
At the visit defined as a progression visit 35% had progressed to ASCUS, 0.37% ASCH, 57% to LGSIL, 7% to HGSIL, and 0.41% to cancer.
Ten (19.2%) and 5 (9.6%) had the diagnosis of LGSIL by cytotechnologists and pathologists, respectively.
The new guidelines do not distinguish between ASC-US and LGSIL in adolescents, because the outcomes of both are similar for these younger women.
Total results (N) (N) (N) (N) Normal 73 304 10 387 ASCUS 12 18 0 30 LGSIL 24 17 2 43 HGSIL 5 0 1 6 Total 114 339 13 464 Table II.
Also, during the initial months, we saw an increase in diagnosis of low-grade squamous intraepithelial lesions (LGSIL), and these were later proven on biopsy to be highly reactive squamous epithelium.
Papanicolaou (Pap) Test and Human Papillomavirus (HPV) Results (the Number of Abnormal Results/Number Tested) Year Pap Results, ASCUS, LGSIL, Negative/Total (%) No.
Further diagnostic studies, such as colposcopy and cervical biopsy, although not contraindicated in pregnancy, are usually deferred until the postpartum period in a patient with atypical squamous cells of unknown significance (ASCUS) or low-grade squamous intraepithelial lesion (LGSIL) (11).
The prototype agent of this kind, imiquimod (Aldara), has been tested in a recently completed phase II study that included 130 women with low-grade squamous intraepithelial lesions (LGSIL).
NORMAL NO BIOPSY ATYPIA OR CYTOLOGY BIOPSY RESULT HPV ON BIOPSY CIN I Normal 6 ASCUS 2 1 10 27 LGSlL 1 1 14 65 HGSlL 2 1 7 Cancer AGUS 1 CIN II OR III CYTOLOGY AND CIS CANCER VAIN Normal 5 2 ASCUS 10 1 LGSlL 49(*) 2 HGSlL 61 Cancer 1 AGUS 2 1 HPV denotes human papillomavirus; CIN I, cervical intraepithelial neoplasia, grade 1; CIN II, cervical intraepithelial neoplasia, grade 2; CIN III, cervical intraepithelial neoplasia, grade 3; CIS, carcinoma in situ; VAIN, vaginal intraepithelial neoplasm; ASCUS, atypical squamous cells of undetermined significance; LGSIL, low-grade squamous intraepithelial lesions; HGSIL, high-grade squamous intraepithelial lesions; AGUS, atypical glandular cells of unknown significance.
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