title: Management of atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesions of the uterine cervix with human papilloma virus infection among young women aged less than 25 years.
abstract: Current ASCCP guidelines recommend repeat cytology 12 months after HPV-positive results in women aged 21-24 years with either atypical squamous cells of undetermined significance (ASCUS) or a low-grade squamous intraepithelial lesion (LSIL). The purpose of this study was to validate an algorithm in such women with ASCUS or LSIL. A multicenter cross-sectional study was carried out at three academic hospitals involving 40,847 Korean women who underwent cervical cancer screening with cytology and HPV testing with or without subsequent colposcopic biopsies between January 2007 and December 2013. Among a total of 3,193 women with available histopathology data, 762 women with ASCUS and 758 with LSIL were HPV-positive. Among HPV-positive women with ASCUS, 38.5% of women aged 21-24 years had ≥CIN2, compared to 20.8% of women aged 30-65 years and 21.1% of the total women. Among HPV-positive women with LSIL, 25.8% aged 21-24 years had ≥CIN2, compared to 21.2% of women aged 30-65 years and 21.9% of the total women. In HPV-positive women with ASCUS/LSIL aged less than 25 years, the prevalence of ≥CIN2 lesions was 34.5%, which was significantly higher than that (21.0%) in women aged ≥25 years. The risk of ≥CIN2 lesions in HPV-positive Korean women aged 21-24 years with ASCUS or LSIL was not lower than that in older women. Colposcopic examination should be considered for management of HPV-positive young women with ASCUS or LSIL. Diagn. Cytopathol. 2016;44:959-963. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Obstetrics and Gynecology, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
authors.forename: Ki-Jin
authors.initials: KJ
authors.lastname: Ryu
authors.affiliation: Department of Obstetrics and Gynecology, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
authors.forename: Sanghoon
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
authors.forename: Kyung-Jin
authors.initials: KJ
authors.lastname: Min
authors.affiliation: Department of Obstetrics and Gynecology, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jin Hwa
authors.initials: JH
authors.lastname: Hong
authors.affiliation: Department of Obstetrics and Gynecology, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jae Yun
authors.initials: JY
authors.lastname: Song
authors.affiliation: Department of Obstetrics and Gynecology, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jae Kwan
authors.initials: JK
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
authors.forename: Nak Woo
authors.initials: NW
authors.lastname: Lee
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D065309:Atypical Squamous Cells of the Cervix / Q000473:pathology* / Q000821:virology; D005260:Female; D061809:Human Papillomavirus DNA Tests / Q000592:standards; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test / Q000592:standards; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000473:pathology* / Q000821:virology; D017410:Practice Guidelines as Topic; D056910:Republic of Korea; D065310:Squamous Intraepithelial Lesions of the Cervix / Q000453:epidemiology / Q000473:pathology* / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000821:virology
keywords: ASCUS; LSIL; Papanicolaou test; human papillomavirus; young women