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Most women with a Pap smear showing minor abnormalities, detected in the framework of cervical cancer screening, do not have or will not develop clinically significant disease. Minor cytological abnormalities are classified by UK cytological criteria as borderline or mild dyskaryosis, which can be translated into international terminology as ASCUS (atypical squamous cells of undetermined significance) or LSIL (low-grade squamous intraepithelial lesions), respectively.
According to a recent meta-analysis, the absolute risk of underlying high-grade cervical intraepithelial neoplasia (grade II or III or worse (CIN2/3+)) among women with ASCUS is on average 9–10% for CIN2+ and 4–5% for CIN3+. For women with LSIL, these risks are about 1.5 to 2 times as high.1 These risks are 10 to 30 times higher than for women with normal cytology. The probability that high-grade CIN will …
Competing interests None.