Women with low-grade abnormalities on Pap smear should be referred for colposcopy.
OBJECTIVE
To assess cytological, colposcopic and histological outcomes in women referred to a teaching hospital dysplasia clinic with low-grade changes on screening Pap smear.


METHODS
Analysis of a computerised database.


RESULTS
Repeating the Pap test was of little value. Fifteen percent of women with low-grade changes on the referral smear had biopsy proven high-grade change. There was little difference in biopsy proven high-grade change in women referred with an 'abnormal smear of uncertain significance' (23%) or 'an abnormal smear of uncertain significance-possible high-grade change' (24%).


CONCLUSIONS
Given these findings and the current medico-legal climate, immediate referral of women with low-grade changes on routine cytology is indicated, and seems a safer option than the more conservative approach of a repeat smear in 6 or 12 months. Further study of the usefulness of separating smears of uncertain significance into high-grade and low-grade categories is warranted. Consumer input into recommendations for management of Pap smear abnormalities is required.
Fairman
Amanda
A
University Department of Obstetrics and Gynaecology, Melbourne, Victoria, Australia.
Tan
Jeffrey
J
Quinn
Michael
M
D001706:Biopsy; D002278:Carcinoma in Situ / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D020681:Colposcopes; D005260:Female; D006801:Humans; D065006:Papanicolaou Test; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D014626:Vaginal Smears / Q000379:methods; D002578:Uterine Cervical Dysplasia / Q000473:pathology*