Cervical intraepithelial neoplasia in adolescents

Three hundred and eleven adolescent patients with abnormal Pap smears were referred for evaluation. Two hundred and ninety-three were evaluated with colposcopy and directed biopsies. Fourteen percent had normal findings, 42% CIN I, 22% CIN II, and 22% CIN III. The distribution of pathologic findings was similar to that in an adult population in the same clinic except that no invasive carcinomas were found in our adolescents. Since there was a predominance of exocervical lesions, only 3% of the patients required diagnostic conization. Ninety-four percent of the adolescents were treated by cryotherapy as compared to 68% of the adults. Since adolescents have significant cervical intraepithelial neoplasia, an abnormal Pap smear should be evaluated and a tissue diagnosis obtained. Outpatient therapy is well suited for the majority of teenagers because the lesions are commonly confined to the exocervix.