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D. K. Ohrt, MD
Lakeville, Minn

JAMA. 1990;263(24):3260.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply. —

Dr Austin correctly points out that there is a literature that supports aggressive clinical follow-up of patients with any form of cytological atypia. He neglects to add that there also exists a substantial literature that supports conservative clinical follow-up for this same group of patients.^1-5 In fact, some of the articles he has cited support that approach. The question of whether to follow up cytological findings of atypia or low-grade squamous intraepithelial lesion conservatively or aggressively has thus long been recognized and clearly remains unresolved. The only unanimity among gynecologists and pathologists on this issue seems to be that some type of further evaluation, either cytological, colposcopic, or both, is indeed mandatory.

The key unresolved question is whether colposcopic follow-up yields better long-term outcomes (ie, preventing and detecting invasive cancer) than does cytological follow-up. As previously stated, this question has not been addressed scientifically. No conclusive . . . [Full Text PDF of this Article]

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