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Cervical dysplasia in adolescents
Jason D Wright1, Rosa M Davila, Karen R Pinto
1Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri 63110, USA. wrightj@msnotes.wustl.edu
Obstetrics and Gynecology
|July 5, 2005
Summary
Adolescents with abnormal Pap tests showing low-grade squamous intraepithelial lesions (LSIL) or high-grade squamous intraepithelial lesions (HSIL) face a significant risk of developing high-grade cervical abnormalities. Close monitoring is essential for these young patients.
Area of Science:
- Gynecology
- Adolescent Medicine
- Oncology
Background:
- Cervical dysplasia incidence is rising in adolescents.
- Limited data exists on Pap test abnormality outcomes in this age group.
- This study addresses the natural history of LSIL and HSIL in adolescents.
Purpose of the Study:
- To determine the natural history and outcomes of adolescents diagnosed with LSIL or HSIL.
- To assess regression, persistence, and progression rates of cervical abnormalities in teenagers.
Main Methods:
- Retrospective review of adolescent patients (≤18 years) with LSIL or HSIL Pap tests (1997-2003).
- Evaluation of follow-up cytologic and histologic samples.
- Calculation of regression, persistence, and progression rates for recorded abnormalities.
Main Results:
- 646 adolescents identified; follow-up available for 477 (LSIL) and 55 (HSIL).
- Among LSIL, 31% showed progressive dysplasia after 36 months; 62% regressed.
- Among HSIL, 50.9% had high-grade abnormalities, and 31% progressed to cervical intraepithelial neoplasia 3 within 36 months.
Conclusions:
- Adolescents with LSIL and HSIL cytology demonstrate a significant risk of progression to high-grade cervical abnormalities.
- The rate of high-grade abnormality development in adolescents mirrors that of adults.
- Close follow-up is crucial for adolescents with cervical cytologic abnormalities.