Evaluation of Papanicolaou smear and effect of sample biopsy in follow-up of cervical dysplasia.

In a prospective study of women with dysplasia, a superficial sampling biopsy of the cervix was carried out as a periodic check of the cytological findings. The relationship of smear and biopsy results was evaluated, as well as the effect of the biopsy procedure on the subsequent course of dysplasia. We found sufficiently close agreement between smear and biopsy results to conclude that smears and biopsies measure similar aspects of dysplasia. It would appear unwise, however, to rely on Papanicolaou smears exclusively in following women with a history of dysplasia, since negative smears in such women may occasionally show dysplasia in the corresponding biopsy. Periodic corroborative biopsy procedures are therefore indicated in the follow-up care of women with a history of dysplasia. There was no evidence that a superficial sampling biopsy significantly altered the short-term course of dysplasia. There was also no evidence of a cumulative effect of repeated sampling biopsies. These results do not rule out possible effects of other forms of biopsy procedures and schedules on the subsequent course of dysplasia.