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Mild Cervical Atypia: A Management Dilemma
Author(s) -
Lim FangKan,
Razvi Khalil,
Ling YeeKiang,
Chong Angela,
Tham KokFun,
Arulkumaran S.
Publication year - 1996
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1996.tb02188.x
Subject(s) - colposcopy , medicine , atypia , biopsy , cervical cancer , pathology , radiology , cancer
EDITORIAL COMMENT: This paper examines those patients with atypia on cervical cytology and their management. The findings reported in this study from Singapore are similar to those in Victoria (Victoria Cervical Cytology Registry, Statistical Report 1994). Of the 117 patients with atypia on cytology, 25% had a histologically proven C1N lesion. In Victoria 949 cases of atypia/HPV were found on cytology in 1994, with 28% having a colposcopy/histology finding of CIN. In Singapore 18% were found to have high‐grade lesions, compared to 13% in Victoria. The policy in Australia when atypica/HPV is reported on cervical cytology is to repeat the smear in 6 months and to refer for colposcopy only if the abnormality persists. This paper argues against such an approach. Our readers should appraise the arguments put forward by the authors. Summary: This study examined 117 patients with mild cervical atypia or atypical squamous cells of uncertain significance; it was found that 25% had histologically proven CIN lesions by colposcopically‐directed punch biopsy or cone biopsy, 18% were found to have at least CIN 2 lesions and there was 1 case of invasive cancer. These data strongly support the recommendation of early colposcopic referral in patients with mild cervical atypia.