Clinical Crossroads Section Editor: Margaret A. Winker, MD, Deputy Editor.
Author Affiliation: Dr Sawaya is Associate Professor, Department of Obstetrics, Gynecology and Reproductive Sciences; Department of Epidemiology and Biostatistics, University of California, San Francisco; and Director of the Cervical Dysplasia Clinic at San Francisco General Hospital.
DR REYNOLDS: Ms G is a 21-year-old woman with a history of abnormal Papanicolaou (Pap) tests.
Ms G first became sexually active at age 19. That year, she had her first gynecologic examination when she visited a doctor to ask for an oral contraceptive pill prescription. Her examination and cytology test were normal. She had annual Pap screening until age 21, when her cytology test (conventional) showed atypical squamous cells of undetermined significance (ASC-US). Her clinician, a nurse practitioner at student health, recommended a repeat cytology test in 6 months. Her repeat test again showed ASC-US, and she was referred to a gynecologist who performed a colposcopy.
Sawaya GF. A 21-Year-Old Woman With Atypical Squamous Cells of Undetermined Significance. JAMA. 2005;294(17):2210-2218. doi:10.1001/jama.294.17.2210