title: Is atypical squamous cells that cannot exclude high-grade squamous intraepithelial lesion clinically significant?
abstract: OBJECTIVE
  To determine the cumulative risk of cervical intraepithelial neoplasia (CIN) 2 or 3 in patients with atypical squamous cells, cannot exclude HSIL (ASC-H).
  
  
  METHODS
  A retrospective analysis was performed to identify patients referred to the dysplasia clinic with ASC-H. Initial evaluation included colposcopy, endocervical curettage, and an ectocervical biopsy, when indicated, in all the patients. A follow-up evaluation was performed at 6 and 12 months. Cumulative histological diagnosis of CIN 2 or 3 at 12 months served as the clinical end point.
  
  
  RESULTS
  Two hundred twenty-nine patients with ASC-H and with a mean age of 32.8 years were evaluated. At the time of initial colposcopy, only 10.0% (23/229; 95% CI = 6.5%-15%) of the patients had histological evidence of CIN 2 or 3. The cumulative risk of CIN 2 or 3 was 12.2% (95% CI = 8%-17%).
  
  
  CONCLUSIONS
  Evaluation of patients with ASC-H with colposcopy does lead to the detection of CIN 2 or 3 but perhaps at a rate lower than previously reported.
authors.affiliation: 1Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Naval Medical Center San Diego, San Diego, CA 92134, USA. mtmchale@nmcsd.med.navy.mil
authors.forename: Michael T
authors.initials: MT
authors.lastname: McHale
authors.forename: Jessica
authors.initials: J
authors.lastname: Souther
authors.forename: John C
authors.initials: JC
authors.lastname: Elkas
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Monk
authors.forename: Terry A
authors.initials: TA
authors.lastname: Harrison
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002584:Cervix Uteri / Q000473:pathology*; D003127:Colposcopy; D004107:Dilatation and Curettage; D004847:Epithelial Cells / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011230:Precancerous Conditions / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology