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Cytological Prediction of Cervical Intraepithelial Neoplasia Grade 3: Does Size of the Lesion Matter?

Objective Our objective was to test the hypothesis that accurate cytological prediction of cervical intraepithelial neoplasia grade 3 (CIN3) is related to the size of the atypical transformation zone. Patients and Methods Data on 340 women in whom CIN3 was diagnosed after large-loop excision of the transformation zone were recorded prospectively on a computerized database. These data were studied with regard to such variables as lesion size, age, parity, contraception use, and smoking status. Results No association was demonstrated between cytological findings and lesion size in accurately predicting CIN3 lesions. A weak association between cytological findings and age was demonstrated: Cytology is more likely to predict CIN3 accurately in women 25 years or older than in women younger than 25 years. Conclusions Accurate cytological prediction of CIN3 is not related to the size of the atypical transformation zone seen at colposcopy. The CIN3 lesions may be present as discrete foci within a background of low-grade changes.