UICC World Cancer Congress 2006

Objective: To assess the management of women in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) with Low-Grade Squamous Intraepithelial Lesions (LSIL) before and after the 2002 published American Society of Colposcopy and Cervical Pathology (ASCCP) guidelines for management of abnormal cervical cytology. The new guideline for managing LSIL excludes the option for repeat Pap tests at set intervals and recommends immediate colposcopy

Methods:We examined the follow-up of women with LSIL in the NBCCEDP from 2000 to 2004 to determine if Program providers changed management of LSIL after the guidelines were published.

Results:There were 19,013 women in the program with an LSIL Pap test result during the study period. The percent of women with an LSIL Pap test followed with colposcopy, by year, was 60.4% in 2000, 55.1% in 2001 and in 2002, 64.1% in 2003 and 62.0% in 2004. The proportion of women having colposcopy following an LSIL Pap result decreased with increasing age for all study years. Women in the youngest age group (18-29 years) were followed more frequently according to the ASCCP guidelines than other age groups. The increase in the percentage of women having colposcopy for the management of LSIL Pap results in 2003, one year after the guidelines were published, suggests a change in provider practices consistent with the new ASCCP guidelines.