Prevalence of high-grade cervical lesion in women with LSIL and HSIL cytology and prevalence of invasive cancer in women cytologically positive for malignancy.

AIM To determine the prevalence of high-grade cervical lesion (CIN 2 or worse, CIN 2+) and the prevalence of invasive cancers in women with LSIL, HSIL and positive for malignancy on cytology, respectively. METHODS A retrospective study of patients undergoing colposcopy in Rajavithi hospital between 2003-2004 was performed. The final diagnosis was based on colposcopy and histology. RESULTS Among 250 women with LSIL and 152 women with HSIL, 28 (11.2%) and 112 (75.7%), respectively, had histology-confirmed high-grade cervical lesions. Invasive cancer was diagnosed in 12 (7.9%) of women with HSIL but in none of the LSIL cases. Among 19 women with positive smears for malignancy, only 7 ( 36.8 %) had histology-confirmed invasive cancer. CONCLUSION The present study confirms that women with HSIL have high prevalence of high-grade cervical lesions and malignancy. Women with LSIL may be managed less aggressively because of the negligible risk of more advanced lesions. Smears positive for malignancy are inconsistent predictors of invasive cancer.