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Predicting absolute risk of CIN3 during post-colposcopic follow-up: results from the ASCUS-LSIL Triage Study (ALTS)
Joan L Walker1, Sophia S Wang, Mark Schiffman
1Department of Obstetrics and Gynecology, University of Oklahoma, Oklahoma City, OK, USA. Joan-walker@ouhsc.edu
Objective:
At present, clinical management of women referred to colposcopy but found to have
Study Design:
Women included in the analyses: (1) were initially referred to ALTS with a community cytologic interpretation of atypical squamous cell of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesions (LSIL); (2) had a colposcopic evaluation and biopsy, if indicated, resulting in a diagnosis
Results:
Women with HPV-negative test results were at low risk for CIN3 regardless of other test results. Among HPV-positive women, increasing absolute risks of CIN3 were observed with increasing cytology severity: 7% (normal), 11% (ASCUS and LSIL), and 45% (HSIL). The highest absolute risk for CIN3 (67%) was observed for HPV-positive women with HSIL and a colposcopic impression of high-grade/cancer on the second colposcopy.
Conclusion:
In the ALTS population, after the first colposcopic diagnosis of
