A randomized trial of basing treatment on human papillomavirus and/or cytology results in low-grade cervical lesion triage

Research output: Contribution to journalArticle


OBJECTIVE: This study was undertaken to compare management algorithms that base treatment with loop electrosurgical excision procedure on human papillomavirus and/or repeat Papanicolaou test smear results. STUDY DESIGN: A randomized trial that referred 674 women with either atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesions cytology results, detected in organized screening to treatment either (1) if they were positive in a repeat Papanicolaou test smear and/or a human papillomavirus test or (2) if they were positive in the repeat Papanicolaou test smear test only. Women who tested positive were treated, regardless of colposcopic findings. RESULTS: There were 208 of 337 (62%) women who were treated in the human papillomavirus /Papanicolaou test smear group (187/337 because of HPV positivity) and 138 of 337 (41%) in the Papanicolaou test smear only group. Histopathologically diagnosed cervical intraepithelial neoplasia grade 2 or worse was found among 112 of 337 (33.2%) women in the human papillomavirus/Papanicolaou test smear group compared with 85 of 337 (25.2%) women in the Papanicolaou test smear only group (P < .05). Twenty-one women with cervical intraepithelial neoplasia 2+ had normal colposcopy. CONCLUSION: For adequate cervical intraepithelial neoplasia 2+ sensitivity, the decision to use loop electrosurgical excision procedure needs to be based on human papillomavirus testing results and should not exclude women with normal colposcopy.


  • Pontus Bjerre
  • Lena Silfverdal
  • Lena Dillner
  • Bjorn Hagmar
  • Henrik Edvardsson
  • Joakim Dillner
  • Agneta Andersson-Ellstrom
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Obstetrics, Gynecology and Reproductive Medicine


  • procedure, loop electrosurgical excision, colposcopy, intraepithelial neoplasia, atypical squamous cells of undetermined significance, cervical, randomized trial
Original languageEnglish
Pages (from-to)24.e1-24.e7
JournalAmerican Journal of Obstetrics and Gynecology
Issue number1
Publication statusPublished - 2008
Publication categoryResearch