Management of cervical dysplasia

Since the 1982 Revised Task Force Report on Cervical Cancer Screening, controversy has developed over the management of mild dysplasia. Recent developments have led some investigators to recommend colposcopy for any degree of cervical dysplasia because of significant false-negative factors in Pap smear reporting and the observation that some patients have lesions more severe than suggested by the cytology. Over a four-year period, all patients with dysplastic smears in the practice were evaluated by colposcopic examination and biopsy. In 20 cases of mild dysplasia, five cases of cancer in situ were found. Considerable variation from the Task Force's report was noted in cytopathologists' recommendations for cytological smears. Judging from the results of this audit, colposcopic evaluation of all dysplastic smears should be considered.