Utility of colposcopy in the management of ASCUS and LSIL in women younger than 25-year-old: A retrospective multicenter study

Abstract

Objective: We aimed to analyze the colposcopy-guided biopsy results in women aged 21-24 years with clinical suspicion for cervical lesion and/or cytological abnormality. Methods: This was a retrospective cohort study conducted on 461 patients undergoing colposcopic examination and biopsy between the ages of 21-24. The colposcopy-guided biopsy results of women with atypical squamous cells of undetermined significance (atypical squamous cells of undetermined significance) cytology were cervical intraepithelial neoplasia (cervical intraepithelial neoplasia) 2 in 9 patients and cervical intraepithelial neoplasia 3 in 5 patients. Results: The colposcopy-guided biopsy results of women with low-grade squamous intraepithelial lesion (low-grade squamous intraepithelial lesion) cytology were cervical intraepithelial neoplasia 2 in 17 patients, cervical intraepithelial neoplasia 3 in 10 patients, and invasive cancer in 1 patient. One of the high-grade squamous intraepithelial lesion (high-grade squamous intraepithelial lesion) patients had invasive cervical cancer. The cytology results of women with cervical intraepithelial neoplasia 1 after 6 months from colposcopy-guided biopsy were atypical squamous cells of undetermined significance (n = 11), and low-grade squamous intraepithelial lesion (n = 6). The cytology results of women with cervical intraepithelial neoplasia 1 after 12 months were atypical squamous cells of undetermined significance in 2 women, and low-grade squamous intraepithelial lesion in 2 women. The cytology results after 12 months from colposcopy-guided biopsy were high-grade squamous intraepithelial lesion in 16 of 433 women who underwent follow-up (3.7%). There were no significant statistically differences between cervical intraepithelial neoplasia 2 patients with and without treatment in terms of cytology results at 6 months (p = 1.00). However, there were significant statistically differences between cervical intraepithelial neoplasia 2 patients with and without treatment in terms of cytology results at 12 months (p = 0.042). Conclusions: Colposcopic examination should perform in women aged 21-24 years with atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion due to the possibility of high-grade squamous intraepithelial lesion and invasive cancer.