Management of suboptimal cytologic smears. Persistent inflammatory smears

In this study, cytologic smears from 161 women presenting with persistent inflammation were reviewed and the cytologic diagnoses compared with the colposcopic and biopsy findings. When colposcopy was performed and information was available for evaluation (102 cases), 62.7% (64 cases) had abnormal colposcopic findings requiring treatment. The similar figure for biopsy was 76.2% (64 of 84 cases). Of significance was the proportion of major advanced abnormalities requiring immediate treatment. Colposcopy and biopsy, respectively, revealed 7.9% and 19.1% of cases with high grade squamous intraepithelial lesions (CIN 2) or worse. These striking data reinforce the importance of recommending colposcopy as a means of managing persistent inflammation in cytologic smears.