title: Atypical squamous cells of undetermined significance, human papillomavirus, and cervical intraepithelial neoplasia 2 or 3 in adolescents: ASC-US, age, and high-grade cervical neoplasia.
abstract: OBJECTIVE
  To determine rates of and factors associated with cervical intraepithelial neoplasia (CIN) 2 or 3 among women with atypical squamous cells of undetermined significance (ASC-US) and oncogenic human papillomavirus (HPV) infection.
  
  
  METHODS
  This is a retrospective review of 357 women with ASC-US and known high-risk HPV infection. To be eligible for inclusion, patients had to have subsequently undergone colposcopic-directed cervical biopsy and/or endocervical sampling. Univariate and multivariable regression analyses were used to estimate crude and adjusted odds ratios of CIN 2 or 3 by risk factors associated with HPV and CIN.
  
  
  RESULTS
  Thirty-three of 215 (15%) women with ASC-US and oncogenic HPV who underwent histological sampling demonstrated CIN 2 or 3. In the adjusted model, only nulliparity (adjusted odds ratio = 2.2, 95% CI = 1.0-4.8) retained a marginal association with the outcome. No significant age-related differences in the prevalence of high-grade disease emerged. The high-grade lesions seen in adolescents consisted of single, small lesions.
  
  
  CONCLUSIONS
  In the light of these findings, and in conjunction with the high rate of oncogenic HPV infection among adolescents with ASC-US, both reflex HPV testing and immediate colposcopy do not appear to be of benefit in the initial management of teenagers with this cytological diagnosis.
authors.affiliation: Department of Obstetrics and Gynecology, Women and Infants' Hospital of Rhode Island, Brown Medical School, Providence, Rhode Island 02905, USA. lboardman@wihri.org
authors.forename: Lori A
authors.initials: LA
authors.lastname: Boardman
authors.forename: Sherry
authors.initials: S
authors.lastname: Weitzen
authors.forename: Cara
authors.initials: C
authors.lastname: Stanko
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services; D000328:Adult; D003127:Colposcopy / Q000706:statistics & numerical data; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D008499:Medical Records; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D011230:Precancerous Conditions / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D015995:Prevalence; D012189:Retrospective Studies; D012237:Rhode Island / Q000453:epidemiology; D012307:Risk Factors; D014218:Triage; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D014626:Vaginal Smears / Q000706:statistics & numerical data; D002578:Uterine Cervical Dysplasia / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology
chemical_list: D004279:DNA, Viral