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Watch and wait for adolescent LSIL regression. (10-Year Study).
BALTIMORE -- Watchful observation by cytology, rather than colposcopy, may be the most appropriate way to manage low-grade squamous intraepithelial lesions in adolescent women because the overwhelming majority of these lesions clear in 36-40 months.
Low-grade squamous intraepithelial lesions (LSIL), the most common manifestation of human papillomavirus (HPV) infection, persist or progress to high-grade lesions or cancer in 20%-30% of adults, Dr. Anna-Barbara Moscicki said at the annual meeting of the Pediatric Academic Societies. However, teens show a much higher regression rate, indicating that colposcopy may not be necessary for this age group.
The 10-year follow-up study of 187 patients aged 13-22 years with LSIL indicated that 95% showed LSIL regression by 36 months after diagnosis; only 3% progressed to high-grade squamous intraepithelial lesions (HSIL). The women were examined every 4 months, and regression was defined as three consecutive negative Pap smears, said Dr. Moscicki of the University of California, San Francisco.
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