Management of initial atypical cervical cytology: a randomized, prospective study

Five hundred twelve patients who presented with initial atypical cervical cytology between February 1982 and February 1983 at Naval Hospital, San Diego were randomized with respect to antibiotic treatment and interval before repeat cytologic examination. Treatment before repeat cytology did not improve the rate of reversion to normal cytology. Reexamination before three months, however, resulted in an increased rate of persistent atypical cytologies. Patients who failed to revert to normal cytology on repeat examination were found to be at substantial risk for development of cervical intraepithelial neoplasia (CIN). To date, adequate follow up and histologic diagnosis has been achieved for 110 such patients, 49 of whom (44.5%) have been found to harbor CIN. Patients in whom initial cytology demonstrated marked atypia unassociated with inflammation are particularly at risk (76.2%) for development of CIN.