Inflammatory cytology, infection and intraepithelial neoplasia

The prognostic implications of minor grades of abnormality on cervical cytology are unclear. Women attending genitourinary medicine clinics who had cytology showing inflammatory changes with or without koilocytosis or borderline dyskaryosis have a high incidence of cervical intraepithelial neoplasia and genital infection. Of 119 patients who had a colposcopically directed cervical biopsy after one smear showing these changes, 46 (38%) had cervical intraepithelial neoplasia. Seventy-eight (57%) of 138 women had genital infection of whom 26 (33%) had a sexually transmitted disease. We recommend vigilant follow-up of borderline cytology including colposcopy if adequate facilities exist.