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Cervical cytology: Evaluation of low-grade squamous intraepithelial lesions (LSIL)

Annekathryn Goodman, MD
Warner K Huh, MD
Section Editor
Barbara Goff, MD
Deputy Editor
Sandy J Falk, MD, FACOG


Cervical cytology became the standard screening test for cancer of the uterine cervix and premalignant cervical lesions with the introduction of the Papanicolaou (Pap) smear in 1941 [1]. The addition of human papillomavirus (HPV) testing to cervical cancer screening strategies has improved detection of cervical neoplasia and allowed further risk stratification.

Cervical cytology findings may be described as atypical squamous cells (ASC), low-grade squamous intraepithelial lesions (LSIL), high-grade squamous intraepithelial lesions (HSIL), atypical glandular cells (AGC), or invasive cervical cancer.

Evaluation of women with cervical cytology with LSIL is reviewed here. Cervical cancer screening strategies and techniques, interpretation of cervical cytology results, follow-up of other abnormal cytology results, and management of cervical neoplasia are discussed separately. (See "Screening for cervical cancer" and "Cervical cancer screening tests: Techniques for cervical cytology and human papillomavirus testing" and "Cervical and vaginal cytology: Interpretation of results (Pap test report)" and "Cervical cytology: Evaluation of atypical squamous cells (ASC-US and ASC-H)" and "Cervical cytology: Evaluation of high-grade squamous intraepithelial lesions (HSIL)" and "Cervical cytology: Evaluation of atypical and malignant glandular cells" and "Cervical intraepithelial neoplasia: Management of low-grade and high-grade lesions".)


Cervical cancer screening co-testing is testing with both cervical cytology (Pap test) and testing for high-risk human papillomavirus (HPV) types (ie, types that are associated with cervical cancer) (table 1). In this discussion, HPV testing refers only to testing for high-risk HPV types, and this testing should be performed using an assay approved by the US Food and Drug Administration or one that is associated with peer-reviewed publications.

Regarding cervical histology, in 2012, the Lower Anogenital Squamous Terminology (LAST) project of the College of American Pathology and American Society for Colposcopy and Cervical Pathology (ASCCP) published changes in the terminology used to describe HPV-associated squamous lesions of the anogenital tract (figure 1) [2,3]. This is described in detail separately. (See "Cervical cytology: Evaluation of atypical squamous cells (ASC-US and ASC-H)", section on 'Terminology'.)

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Literature review current through: Nov 2017. | This topic last updated: Sep 13, 2017.
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