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Treatment options for low-grade squamous intraepithelial lesions of the cervix

Question

Dear OncoLink "Ask The Experts,"

I recently had a colposcopy, and had 4 biopsies taken from the four lesions found on my cervix. The results have come back as a low-grade abnormal type. I am being told to leave the lesions there, and be tested every six months. Isn't that a clue that I am a very high risk for these lesions to advance into a more serious matter? I guess I'm upset because I feel like I am getting different treatment because I'm poor, and being tested every six months is not only very inconvienient, and increases my stress, but it is very expensive, what should I do?  


Answer

Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:

There are generally two options after the diagnosis of low-grade squamous intraepithelial lesions has been confirmed by biopsy:

  • follow up with repeat Pap tests every 4-6 months,
  • or local excision such as LEEP biopsy.
Because low grade lesions of the cervix rarely progress to cancer, and 60% may regress (or go away) on their own without additional treatment, avoiding surgical removal is a very reasonable option. I don't think you should feel that you are receiving inappropriate treatment because you are poor. The follow up plan that was recommended to you is standard. Besides, even after a surgical procedure to remove the lesions, you may still need to have more frequent Pap tests for a time.

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