POEMs

Repeat Cytology Within Six Months Equals Colposcopy for Younger Women with ASCUS or LSIL

 

Am Fam Physician. 2017 Apr 1;95(7):455.

Clinical Question

Is colposcopy with biopsy better than repeat cytology alone within six months to prevent invasive cervical neoplasia?

Bottom Line

Among women 22 to 27 years of age with an index cervical cytology showing abnormal squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL), the incidence of invasive cervical cancer did not differ between repeat cytology within six months or colposcopy with biopsy within six months. For women 28 years or older, there was an increased risk of invasive disease with the repeat cytology approach. Among the younger women, there was an increased incidence of invasive disease using an interval for cytology of seven to 12 months. An initial follow-up approach for the younger group using cytology only within six months would avoid 27% of colposcopic procedures

POEMs (patient-oriented evidence that matters) are provided by EssentialEvidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP, search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of POEMs published in AFP is available at http://www.aafp.org/afp/poems.


 

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