Cervical smear histories of 585 women with biopsy-proven carcinoma in situ.

Abstract

To analyze the cervical cytologic smear history of women with carcinoma in situ (CIS). We examined cytologic smears obtained within the three-year period prior to a histologic diagnosis of CIS in 585 women for whom at least one prebiopsy smear was available. Among 454 patients with only one smear available for review, 9 (2%) had a negative cytologic diagnosis, 58 (13%) had low grade squamous intraepithelial lesion (LSIL), and 387 (85%) had high grade squamous intraepithelial lesion (HSIL). One hundred thirty-one women had two to five smears taken within the previous three years available for review. All the smears taken prior to biopsy showed HSIL. The original diagnosis on the other smears was negative for 78 women (60%), HSIL for 46 (35%) and LSIL for 7 (5%). ALl 132 smears originally classified as negative from 87 of 585 (14.8%) women were reviewed. Twenty-seven (20%) were then classified as showing HSIL, 10 as LSIL, 10 as atypical squamous cells of undetermined significance, 7 as unsatisfactory and 78 (59%) as remaining negative. Of smears classified as negative and taken in the three years before biopsy-proven CIS, 41% were reclassified, with half reclassified as showing HSIL.