Low-grade squamous intraepithelial lesion on Papanicolaou test: follow-up rates and stratification of risk for high-grade squamous intraepithelial lesion

HPV infection - Screening, diagnosis and management of HPV-induced lesions

“…(19) These two cytological categories have very similar risks of progressing to HSIL and can be managed in a similar way. (20,21) On the other hand, the reliability of oncotic cytology is important, since the diagnosed LSIL can be associated with the presence of histological HSIL, demonstrating that most of these lesions already existed previously and did not correspond to the evolution of less severe lesions. (20)(21)(22) The advent of HPV DNA testing allowed risk stratification in patients with LSIL/ASC-US.…”

“…(17,18) Detection of high-risk HPV DNA in LSIL is associated with a higher risk of progression to HSIL. (21)(22)(23) Studies have already demonstrated the significant benefits of using the HPV DNA testing in dubious cytologies. (20,21,(23)(24)(25) How should we conduct LSIL?…”

“…(21)(22)(23) Studies have already demonstrated the significant benefits of using the HPV DNA testing in dubious cytologies. (20,21,(23)(24)(25) How should we conduct LSIL? Recommendations for patients with a cytopathological diagnosis of LSIL/ASC-US range from immediate referral to colposcopy, repeat cytology or HPV DNA testing with referral to colposcopy if the result is positive.…”

“…Recommendations for patients with a cytopathological diagnosis of LSIL/ASC-US range from immediate referral to colposcopy, repeat cytology or HPV DNA testing with referral to colposcopy if the result is positive. (7,19,(20)(21)(22)(23)(24)(25) Several protocols recommend similar approaches for the cytopathological diagnosis of LSIL and ASC-US: (7,20) • <25 years of age: repeat cytology in three years; • 25-29 years of age: repeat the cytology in 12 months; • ≥30 years of age: repeat the cytology in six months; • Treat infectious processes or atrophy; • If the repeat cytology is negative in two consecutive exams, return to routine screening; • If one of subsequent cytologies is positive, perform colposcopy; • Indicate colposcopy for immunocompromised women with cytopathological examination showing LSIL.…”

“…In a recent protocol (2019), the(American Society for Colposcopy and Cervical Pathology (ASCCP) recommended that patients under 25 years of age presenting LSIL cytology, HPV-positive ASC-US or ASC-US without HPV DNA test should repeat isolated cytology one and two years after the initial abnormal result. (21) In patients with ASC-US and negative HPV DNA test, repeat the cytology in three years. After two negative cytological tests, return to routine age-based screening.…”