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Anna-Barbara Moscicki

Adolescents remain vulnerable to human papilloma virus (HPV) infection because of certain physiologic characteristics inherent in this age group and common sexual behaviors, including lack of condom use. The commonness of HPV in this age group also results in frequent abnormal cytology. Fortunately, most of the infections are transient, with frequent clearance of HPV and the lesion. Current strategies for adolescents with abnormal cytology include conservative management, avoiding invasive procedures. For cytologic atypical squamous cells of undetermined significance or squamous intraepithelial lesions (SIL), management can be obtaining cytology only at 1-year intervals for up to 2 years before referral for colposcopy is necessary. For biopsy-proven cervical intraepithelial neoplasia (CIN) I, management is similar with yearly cytology indefinitely or until high-grade–SIL or CIN II/III develops. CIN II in adherent adolescents can be managed with 6-month cytology and colposcopy.

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J. Thomas Cox

results . JAMA 1999 ; 281 : 1605 – 1610 . 97 ASCUS-LSIL Triage Study (ALTS) Group . Results of a randomized trial on the management of cytology interpretations of atypical squamous cells of undetermined significance . Am J Obstet Gynecol

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Rodger J. Winn

Reference 1 The ASCUS-LSIL Triage Study (ALTS) group . Results of a randomized trial in the management of cytology interpretations of atypical squanous cells of undetermined significance . Am J Obstet Gynecol 2003 ; 188 : 1383 – 1392 .

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Kathleen N. Moore and Joan L. Walker

: baseline results from a randomized trial . J Natl Cancer Inst 2001 ; 93 : 293 – 299 . 14 The ASCUS-LSIL Triage Study (ALTS) Group . Results of a randomized trial on the management of cytology interpretations of atypical squamous cells of

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Edward E. Partridge, Nadeem R. Abu-Rustum, Susan M. Campos, Patrick J. Fahey, Michael Farmer, Rochelle L. Garcia, Anna Giuliano, Howard W. Jones III, Subodh M. Lele, Richard W. Lieberman, Stewart L. Massad, Mark A. Morgan, R. Kevin Reynolds, Helen E. Rhodes, Diljeet K. Singh, Karen Smith-McCune, Nelson Teng, Cornelia Liu Trimble, Fidel Valea, and Sharon Wilczynski

lesions (LSIL; except in postmenopausal women), or high-grade squamous intraepithelial lesions (HSIL) cytology ( http://www.asccp.org/pdfs/consensus/clinical_update_20090408.pdf ). 2 See HPV DNA Testing on page 1378 for more detail. Screening options

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Kristopher J. Kimball and Warner K. Huh

Gynecol 2007 ; 196 : 206 – 212 . 3. ASCUS-LSIL Triage Study (ALTS) Group . Results of a randomized trial on the management of cytology interpretations of atypical squamous cells of undetermined significance . Am J Obstet Gynecol 2003 ; 188

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Philip E. Castle

. Stoler MH Schiffman M . Interobserver reproducibility of cervical cytologic and histologic interpretations: realistic estimates from the ASCUS-LSIL Triage Study . JAMA 2001 ; 285 : 1500 – 1505 . 7. Kurman RJ Henson DE Herbst AL . Interim

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L. Stewart Massad

significance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL), that usually are not associated with precancer yet are common enough to account for most precancers diagnosed in screened populations. 3 , 4 Accurate tests for human papillomavirus

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Howard A. Chang, Saro H. Armenian, and Thanh H. Dellinger

as low-grade and high-grade squamous intraepithelial lesions (LSIL and HSIL, respectively). Histology-confirmed koilocytic changes found on colposcopic biopsy are denoted, in increasing severity, as cervical intraepithelial neoplasia grades 1, 2, and

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Edward E. Partridge, Nadeem Abu-Rustum, Anna Giuliano, Stewart Massad, Joan McClure, Mary Dwyer, and Miranda Hughes

-grade squamous intraepithelial lesion (LSIL); (3) atypical squamous cell suspicion of high-grade dysplasia (ASC-H); (4) HSIL; and (5) invasive carcinoma. Colposcopy, along with colposcopically directed biopsies, may be indicated for evaluating women with abnormal