Paired papanicolaou smears in the evaluation of atypical squamous cells

Between February 1985 and April 1988, 360 women were seen at Tripler Army Medical Center’s cervical clinic as part of a prospective study to assess the value of paired Papanicolaou smears in the follow-up of atypical squamous cells in a cervical cytologic smear. The evaluation consisted of paired repeat Papanicolaou smears and colposcopy. Colposcopically directed biopsies and/or endocervical curettage were performed in 86% of the subjects. The results of the paired Papanicolaou smears were negative/negative in 202 patients (56%). Cervical intraepithelial neoplasia was diagnosed histopathologically in 16% of all patients and in 10% of those with negative/negative repeat smears. We conclude that the presence of atypical squamous cells in a Papanicolaou smear should be considered abnormal and that colposcopy and colposcopically directed biopsies should be performed for these patients.