ATYPICAL SQUAMOUS CELLS OF UNDETERMINED SIGNIFICANCE - MANAGEMENT PATTERNS AT AN ACADEMIC-MEDICAL-CENTER

OBJECTIVE: Our intent was to compare the management of patients with a typical squamous cells of undetermined significance on cytologic scree ning at an academic center to published guidelines. STUDY DESIGN: We r eviewed the management of 223 atypical squamous cells of undetermined significance cervical smears. Patients with a history of dysplasia wer e excluded. The time interval to and nature of follow-up testing was d etermined, and the influence of atypical squamous cells of undetermine d significance qualifiers and provider specialty analyzed. RESULTS: In itial follow-up consisted of repeat cytologic examination alone in 94% of cases. Of patients with follow-up, 29% were retested within 2 mont hs and 68% within 4 months. No conclusive differences in management we re found by qualifier type or by provider specialty. Subsequent high-g rade dysplasia was found in 2.6% of patients. CONCLUSIONS: A discrepan cy exists between published guidelines and actual management of patien ts with atypical squamous cells of undetermined significance smears at this medical center. Patients often undergo follow-up testing at shor ter intervals than those suggested despite a low likelihood of finding high-grade disease.