Outcome after a cervical cytology report of low-grade squamous abnormality in Australia

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Abstract
BACKGROUND The current study was undertaken to assist with providing an evidence‐based approach to the management of women with cervical cytology reports of low‐grade squamous abnormality as used in the Australian organized screening program. METHODS Using the Pap Test Registers, an audit was performed of the outcome over 24 months of Australian women who received an index cervical cytology report of low‐grade squamous abnormality in 1999. RESULTS Information was available for 76,709 of the 90,566 women whose first cytology report in 1999 was of a low‐grade squamous abnormality. Forty‐one cases of histologically confirmed cervical carcinoma were diagnosed during the subsequent 24 months (10 Stage IA, 31 Stage IB or worse). Five of the 10 women who were diagnosed with Stage IA carcinoma during the 24 months of follow‐up had an intervening cervical biopsy of high‐grade intraepithelial abnormality. The risk of cervical carcinoma diagnosis during the 24 months was 0.05% (95% confidence interval [CI], 0.03–0.07%) for the women with nonspecific minor change index cytology, 0.03% (95% CI, 0.00–0.07%) for the women with human papillomavirus index cytology, and 0.07% (95% CI, 0.03–0.11%) for the women with Grade 1 cervical intraepithelial neoplasia index cytology. CONCLUSIONS Cervical carcinoma was a very rare outcome within 2 years of a cytology report of low‐grade squamous abnormality in Australia. A simplified terminology for low‐grade squamous cervical cytology reports should be considered by Australia, with uniform management for asymptomatic women. Cancer (Cancer Cytopathol) 2005. © 2005 American Cancer Society.