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Sao Paulo Med J. 2014;132(1):15-22. doi: 10.1590/1516-3180.2014.1321597.

Follow-up of women with atypical squamous cells cannot exclude high-grade squamous intraepithelial lesions (ASC-H).

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  • 1Department of Nursing, School of Nursing, Universidad Andres Bello, Santiago, Chile.
  • 2Universidade de Caxias do Sul, Department of Obstetrics and Gynecology, Rio Grande do Sul, Brazil, MD. Professor, Department of Obstetrics and Gynecology, Universidade de Caxias do Sul, Rio Grande do Sul, Brazil.
  • 3Complejo Asistencial Barros Luco, Santiago, Chile, Medical Technologist. Cytology Laboratory, Complejo Asistencial Barros Luco, Santiago, Chile.



The concept that the presence of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesions (ASC-H) was introduced in the 2001 Bethesda System of cervical cytology classification. This nomenclature defines cervical cancer precursor lesions. The objective of this study was to investigate the colpocytological-histological results from a three-year follow-up conducted on a cohort of women with reports of ASC-H who were attended during 2005-2006 at clinics of the Southern Metropolitan Healthcare Service of Santiago, Chile.


Prospective cohort study at primary healthcare clinics in Santiago, Chile.


Colpocytological-histological follow-up was conducted over a three-year period on 92 women with cytological reports of ASC-H who were attended at primary healthcare clinics during 2005-2006.


At the end of the follow-up period, high-grade lesions were evaluated and the following outcomes were observed: seven women presented invasive cancer (7.6%), 49 presented high-grade lesions (53.3%), 26 presented low-grade lesions (28.2%) and 10 presented normal results (10.9%). The "Conditional Probabilities Tree Diagram" was used to show the results from tests and the times of lesion detection. It demonstrated that, after a first report of ASC-H, clinical management needed to be interventionist.


The follow-up on our cohort of women showed that the majority of uncertain ASC-H diagnoses (82.6%) had abnormal colposcopic results and that during the follow-up using ASC-H smears, two out of every three women developed high-grade lesions.

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