Treatment of women with low-grade squamous intraepithelial lesions on cytologic evidence or biopsy results by board-certified gynecologists.

Abstract

The Bethesda system combined human papillomavirus effects and mild dysplasia/cervical intraepithelial neoplasia grade 1 into a single category called low-grade squamous intraepithelial lesion. We sought to determine whether the treatment of women with low-grade squamous intraepithelial lesions by board-certified gynecologists was different for human papillomavirus effect versus mild dysplasia/cervical intraepithelial neoplasia grade 1. In addition, we sought to document the prevalence of human papillomavirus testing and counseling regarding sexual partners by this group of providers. A 2-page survey was mailed in April 1998 to a random sample of 491 fellows of the American College of Obstetrics and Gynecology. The response rate was 50.6%. For a Papanicolaou test with human papillomavirus effects, 52% of the respondents would perform colposcopy. For a Papanicolaou test with mild dysplasia/cervical intraepithelial neoplasia 1, 86% of the respondents would perform colposcopy (P <.0001). For biopsy-proved condyloma, 33% of the respondents would treat the patient. For biopsy-proved mild dysplasia/cervical intraepithelial neoplasia grade 1, significantly more respondents would treat the patient (45%, P =.02). Respondents rarely offered routine human papillomavirus testing and frequently made recommendations regarding partner examination and condom use. Board-certified gynecologists commonly treat women with a newly diagnosed low-grade squamous intraepithelial lesion Papanicolaou test with colposcopy and frequently differentiate between human papillomavirus effects and mild dysplasia/cervical intraepithelial neoplasia grade 1 in the treatment.