title: Speculoscopy for Triage of Patients with an Abnormal Pap Smear: Data from the GISPE Study.
abstract: OBJECTIVE
  This study evaluates the performance of Papanicolaou smear combined with speculoscopy in improving the predictive value of minor grade cervical cytological abnormalities.
  
  
  METHODS
  A total of 3,300 asymptomatic women who had routine cervical smears were studied in 32 Italian centers. All these women underwent Pap smear and speculoscopy. The women positive at Pap smear or speculoscopy (n = 908) were referred for colposcopy and directed punch biopsy/endocervical curettage was performed when appropriate.
  
  
  RESULTS
  Of the 908 patients referred for colposcopy, 538 underwent biopsy; 92 of these had a cervical lesion (cervical intraepithelial neoplasia [CIN]) confirmed on histology (67 CIN1 and 25 CIN2-3). Speculoscopy pointed out an area to biopsy in 84% of the CIN1 and in 75% of the CIN2-3 cases among women who showed minor (low-grade squamous intraepithelial lesion or less) cytological abnormalities.
  
  
  CONCLUSIONS
  The potential combination of cytology and speculoscopy as an intermediate test in patients with minor grade cytologic (atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion) cervical changes may decrease the number of recalls and directed biopsies in a cost-effective manner.
authors.affiliation: *Department of Obstetrics and Gynecology, University of Bologna, Bologna, Italy; †Department of Pathological Anatomy, University of Siena, Siena, Italy; and ‡Italian Medical Department, BRACCO S.p.A., Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Costa
authors.forename: M
authors.initials: M
authors.lastname: De Nuzzo
authors.forename: P
authors.initials: P
authors.lastname: Terzano
authors.forename: K
authors.initials: K
authors.lastname: Syrjänen
authors.forename: R
authors.initials: R
authors.lastname: Abbiati
authors.forename: E
authors.initials: E
authors.lastname: Grossi
authors.forename: G
authors.initials: G
authors.lastname: Quagliarella
authors.forename: A
authors.initials: A
authors.lastname: Bovicelli
authors.forename: A
authors.initials: A
authors.lastname: Zamparelli
authors.forename: L
authors.initials: L
authors.lastname: Bovicelli