Treatment options for carcinoma in situ of the cervix

Stephen C. Rubin, MD
Last Modified: April 21, 2002

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Question

Dear OncoLink "Ask The Experts,"
Last July I had a cone biopsy done for diagnosis and treatment of carcinoma in situ--I was told after surgery that my margins were clear. In January of this year my gyn resumed pap testing again. The results were ASCUS. He repeated the pap again in March and the results were ASCUS again. I've now been referred to a gyn oncologist. What should I expect to happen now? Should I prepare myself for a hysterectomy?  

Answer

Stephen C. Rubin, MD, Professor and Chief of the Division of Gynecologic Oncology, University of Pennsylvania Health System, responds:

Cervical conization, or other ablative procedures, are approximately 90% effective in eliminating carcinoma-in-situ (surface cancer). The fact that you have had two recent Pap tests showing ASCUS (atypical cells) could be a sign that the carcinoma-in situ is returning, or it could be an indication of something less serious. I'm sure the gynecologic oncologist will want to perform a colposcopy and cervical biopsies to clarify the situation. If you again have a significant abnormality, hysterectomy could be an option, although lesser procedures could be considered.