Treatment of high-grade squamous intraepithelial lesions: A 2- versus 3-step approach

Abstract Objective The purpose of this study was to determine whether colposcopically directed biopsy is a necessary step in the evaluation of patients with high-grade squamous intraepithelial lesions. Study design A retrospective analysis was conducted of the correlation between the high-grade squamous intraepithelial lesion Papanicolaou test and the colposcopically directed biopsy and the correlation between the high-grade squamous intraepithelial lesion Papanicolaou test and the loop electrosurgical excisional procedure. Results Of 72 patients with high-grade squamous intraepithelial lesions on Papanicolaou test, 48 patients had a pathologic diagnosis on cervical biopsy of CIN II or greater, which provides a 67% correlation between the Papanicolaou test and the colposcopically directed biopsy. Fifty-six patients had a pathologic diagnosis on loop electrosurgical excisional procedure of CIN II or greater, which provides a 78% correlation between the Papanicolaou test and the loop electrosurgical excisional procedure. The median interval between the Papanicolaou test and the definitive treatment was significantly longer ( P Conclusion The colposcopically directed loop electrosurgical excisional procedure after a high-grade squamous intraepithelial lesion Papanicolaou test may reduce the time interval between diagnosis and treatment; furthermore, it offers equal correlation when compared with traditional treatment.