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Background: Although the incidence of cervical dysplasia in adolescents is increasing, a paucity of data exists regarding the outcomes of adolescents with Pap test abnormalities. We determined the natural history and outcome of adolescents with low- grade squamous intraepithelial lesions (LSIL) and highgrade squamous intraepithelial lesions (HSIL). Methods: A review of ail women aged 18 years or younger with a cytologic diagnosis of LSIL or HSIL between 1997 and 2003 was performed. Follow- up cytologic and histologic samples were evaluated. The most significant abnormality was recorded for each patient. Rates of regression, persistence, and progression were calculated. Results: A total of 646 arolescents were identified. Follow- up was available for 477 teenagers with LSIL and for 55 with HSIL. Among adolescents with LSIL, 146 (35% ) had negative follow- up. Low- grade abnormalities (atypical squamous cells of undetermined significance, LSIL, and cervical intraepithelial neoplasia grade 1) were seen in 199 (47% ), whereas high- grade abnormalities were documented in 77 (18% ). After 36 months, 62% had regressed, whereas 31% had progressive dysplasia. For the HSIL cohort, negative follow- up was documented in 12 (21.8% ) adolescents, and 15(27.3% ) had low- grade abnormalities, whereas more than one half (50.9% ) were found to have a high- grade abnormality. At 36 months, 31% of HSIL subjects had progressed to cervical intraepithelial neoplasia 3. Conclusion: Adolescents with LSIL and HSIL cytology are at significant risk for progression to high- grade cervical abnormalities. The rate of development of high- grade cervical abnormalities in adolescents is similar to adults. Adolescents with cytologic abnormalities mandate close follow- up.
Background: Although the incidence of cervical dysplasia in adolescents is increasing, a paucity of data exists regarding the outcomes of adolescents with Pap test abnormalities. We determined the natural history and outcome of adolescents with low-grade squamous intraepithelial lesions (LSIL) and highgrade squamous Methods: A review of ail women aged 18 years or younger with a cytologic diagnosis of LSIL or HSIL between 1997 and 2003 was performed. Follow-up cytologic and histologic samples were evaluated. The most significant abnormality was recorded for Results: A total of 646 arolescents were identified. Follow-up was available for 477 teenagers with LSIL and for 55 with HSIL. Among adolescents with LSIL, 146 (35%) had negative follow- up. Low-grade abnormalities (atypical squamous cells of undetermined significance, LSIL, and cervical intraepithelial neoplasia grad For 36 hours, 62% had regressed, but 31% had progressive dysplasia. For the HSIL cohort, negative follow- At least (36%) had low-grade abnormalities, more than one half (50.9%) were found to have a high grade abnormality. At 36 months, 31% of HSIL subjects had progressed to cervical intraepithelial neoplasia 3. Conclusion: Adolescents with LSIL and HSIL cytology are at significant risk for progression to high- grade cervical abnormalities. The rate of development of high- grade cervical abnormalities in adolescents is similar to adults. Adolescents with cytologic abnormalities mandate close follow-up.