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Page: << Prev | 1 | 2 But is this expensive, invasive follow-up test always necessary in young patients with LSIL test results?
In a study in the Nov. 6 issue of The Lancet, Dr. Anna-Barbara Moscicki and colleagues at the University of California, San Francisco, examined 10 years of data on the cervical health of nearly 900 patients between 13 and 22 years of age. All of the women received Pap smears once every four months during the course of the study.
About 187 of these young women received at least one LSIL test result during the study period, the researchers reported. However, 61 percent of these low-grade lesions simply disappeared on their own within a year after diagnosis, with that rate rising to 91 percent by three years post-diagnosis, according to the investigators.
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The findings confirm "the benign nature of this condition in adolescent and young women," the researchers said.
In an accompanying commentary in the journal, British Drs. Anne Swarewski and Peter Sasieni said they believe the UCSF team has "clearly shown just how common and meaningless LSIL is in young women." They concluded there is "no role for colposcopy in adolescents as part of routine [gynecologic] management."
But Wright said he wouldn't go quite that far.
He agreed with the British doctors that "there is a very low rate of significant disease among adolescents, especially. What we'd classify as 'disease' here is usually nothing more than an acute viral infection that usually goes away."
On the other hand, he said, the study "isn't saying that we don't do follow-up" when young women receive a Pap test result with LSIL.
"The study authors are just saying 'wait a while' before initiating colposcopy. I do think that's the right tack -- it's not that you don't ever need to do colposcopy, it's that you don't need to do it immediately," Wright said. "First, give the lesion a chance to regress."
If the lesion persists through subsequent Pap smears, colposcopy may be warranted, even in young women, he said.
However, the new study should ease the fears of young women who receive abnormal Pap results. According to Wright, the findings offer up yet more proof that "cervical cancer or significant disease is very uncommon in this age group."
More information
To learn more about the Pap test, visit the American Cancer Society (www.cancer.org ). Page: << Prev | 1 | 2
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