FOLLOW-UP OF WOMEN WITH A HISTORY OF MILDLY ABNORMAL CERVICAL SMEARS WHICH HAVE RETURNED TO NORMAL WITHOUT TREATMENT

The progress of 124 women with at least two negative cervical smears f ollowing a history of mildly abnormal smears for which no treatment ha d been given was compared with 106 women with negative smears and a cl inical history of genital warts or herpes virus infection and 460 age- matched controls. After 4 years, excluding those for whom there was no follow up, 5.8% of those with a history of abnormal smears, none of t hose with a clinical history of genital warts or herpes virus and 1.1% of controls had developed histological evidence of at least cervical intraepithelial neoplasia grade III (CINIII) when referred for investi gation of subsequent abnormal smears; one woman, from the control grou p, had developed invasive cervical cancer. Women with two negative sme ars after a history of abnormal smears who subsequently developed CINI II were more likely to have had a previous smear reported as moderate or mild-moderate dyskaryosis (2/6) compared with those whose follow up was negative (2/89). The results suggest that two negative cervical s mears may not necessarily indicate that a lesion has regressed, but th at a clinical history of genital warts or herpes virus infection shoul d not be an indication for increased surveillance.