Treatment of women with low-grade squamous intraepithelial lesions on cytologic evidence or biopsy results by board-certified gynecologists.
OBJECTIVE
The Bethesda system combined human papillomavirus effects and mild dysplasia/cervical intraepithelial neoplasia grade 1 into a single category called low-grade squamous intraepithelial lesion. We sought to determine whether the treatment of women with low-grade squamous intraepithelial lesions by board-certified gynecologists was different for human papillomavirus effect versus mild dysplasia/cervical intraepithelial neoplasia grade 1. In addition, we sought to document the prevalence of human papillomavirus testing and counseling regarding sexual partners by this group of providers.


METHODS
A 2-page survey was mailed in April 1998 to a random sample of 491 fellows of the American College of Obstetrics and Gynecology. The response rate was 50.6%.


RESULTS
For a Papanicolaou test with human papillomavirus effects, 52% of the respondents would perform colposcopy. For a Papanicolaou test with mild dysplasia/cervical intraepithelial neoplasia 1, 86% of the respondents would perform colposcopy (P <.0001). For biopsy-proved condyloma, 33% of the respondents would treat the patient. For biopsy-proved mild dysplasia/cervical intraepithelial neoplasia grade 1, significantly more respondents would treat the patient (45%, P =.02). Respondents rarely offered routine human papillomavirus testing and frequently made recommendations regarding partner examination and condom use.


CONCLUSIONS
Board-certified gynecologists commonly treat women with a newly diagnosed low-grade squamous intraepithelial lesion Papanicolaou test with colposcopy and frequently differentiate between human papillomavirus effects and mild dysplasia/cervical intraepithelial neoplasia grade 1 in the treatment.
Lee
Chris
C
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California at San Francisco, 94143, USA.
Mancuso
Victoria
V
Contant
Tracy
T
Jackson
Rebecca
R
Smith-Mccune
Karen
K
D000328:Adult; D001706:Biopsy; D002568:Certification; D003127:Colposcopy; D005260:Female; D006075:Governing Board; D006176:Gynecology; D006801:Humans; D065006:Papanicolaou Test; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000150:complications; D011364:Professional Practice; D014412:Tumor Virus Infections / Q000150:complications; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000628:therapy* / Q000821:virology; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000628:therapy* / Q000821:virology