Cervical dysplasia in adolescents. Obstet Gynecol 2005 Jul;106(1):115-20
Date
07/05/2005Pubmed ID
15994625DOI
10.1097/01.AOG.0000165822.29451.54Scopus ID
2-s2.0-21244477099 (requires institutional sign-in at Scopus site) 64 CitationsAbstract
BACKGROUND: Although the incidence of cervical dysplasia in adolescents is increasing, a paucity of data exists regarding the outcomes of adolescents with Pap test abnormalities. We determined the natural history and outcome of adolescents with low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL).
METHODS: A review of all women aged 18 years or younger with a cytologic diagnosis of LSIL or HSIL between 1997 and 2003 was performed. Follow-up cytologic and histologic samples were evaluated. The most significant abnormality was recorded for each patient. Rates of regression, persistence, and progression were calculated.
RESULTS: A total of 646 adolescents were identified. Follow-up was available for 477 teenagers with LSIL and for 55 with HSIL. Among adolescents with LSIL, 146 (35%) had negative follow-up. Low-grade abnormalities (atypical squamous cells of undetermined significance, LSIL, and cervical intraepithelial neoplasia grade 1) were seen in 199 (47%), whereas high-grade abnormalities were documented in 77 (18%). After 36 months, 62% had regressed, whereas 31% had progressive dysplasia. For the HSIL cohort, negative follow-up was documented in 12 (21.8%) adolescents, and 15 (27.3%) had low-grade abnormalities, whereas more than one half (50.9%) were found to have a high-grade abnormality. At 36 months, 31% of HSIL subjects had progressed to cervical intraepithelial neoplasia 3.
CONCLUSION: Adolescents with LSIL and HSIL cytology are at significant risk for progression to high-grade cervical abnormalities. The rate of development of high-grade cervical abnormalities in adolescents is similar to adults. Adolescents with cytologic abnormalities mandate close follow-up.
LEVEL OF EVIDENCE: II-3.
Author List
Wright JD, Davila RM, Pinto KR, Merritt DF, Gibb RK, Rader JS, Mutch DG, Gao F, Powell MAAuthor
Janet Sue Rader MD Chair, Professor in the Obstetrics and Gynecology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAge Factors
Biopsy, Needle
Child
Cohort Studies
Cytodiagnosis
Female
Follow-Up Studies
Humans
Immunohistochemistry
Precancerous Conditions
Probability
Retrospective Studies
Risk Assessment
Uterine Cervical Dysplasia
Uterine Cervical Neoplasms
Vaginal Smears
