ROUTINE COLPOSCOPIC EVALUATION OF PATIENTS WITH PERSISTENT INFLAMMATORY CELLULAR-CHANGES ON PAP SMEAR

Objective: To assess the rate of undetected dysplasia in patients with two consecutive reports of inflammatory cellular changes without atyp ia on Pap smears despite anti-inflammatory therapy. Method: A prospect ive randomized study. Result: 2798 premenopausal non-pregnant patients were evaluated by Pap smears of the cervix. Of these, 397 (14.2%) wer e reported as 'inflammatory cellular changes'. A total of 238 (8.5%) h ad persistent Inflammatory changes without atypia despite the anti-inf lammatory therapy. Fourteen patients refused colposcope. The mean age and parity of the remaining 224 patients were 30.2 +/- 6.3 (18-46) and 1.7 +/- 2.3 (0-6), respectively. When these patients underwent colpos copically-directed biopsies of the cervix, in 51 (22.7%) patients huma n papillomavirus lesions, dysplasia and in situ cancer were noted. Mea n age, parity, age of marriage, prevalence of smoking and contraceptiv e methods of the two groups of patients (173 vs. 51) did not show stat istically significant differences. Conclusion: Colposcopically-directe d biopsies of the cervix are indicated even when inflammatory cellular changes without atypia persist despite therapy. (C) 1997 Internationa l Federation of Gynecology and Obstetrics.