You Heard It Here First: Don't Over Treat Cervical Abnormalities in Teens

The American College of Obstetricians and Gynecologists (ACOG) has issued new guidelines on how to treat adolescents who receive abnormal results from their Pap tests. (The Pap test identifies cervical abnormalities, called "intraepithelial neoplasia", which might indicate the presence of cancer.) ACOG’s new guidelines stress going slowly and avoiding invasive treatment for most teens.

Scientific evidence concludes that most cervical intraepithelial neoplasia (CIN) at grades 1 and 2 naturally and spontaneously resolve in teens. Further, surgical excision or destruction of cervical tissue could affect the teen’s future fertility and cervical function. ACOG now recommends monitoring teens with an abnormal Pap at six-month intervals, and only performing a colposcopy (a procedure to examine the vaginal walls and cervix) if cytology results are repeatedly abnormal. ACOG also stresses that performing a simultaneous Loop Electrosurgical Excision Procedure (LEEP) during colposcopy should be avoided in most teens, because of the high rate of resolution of cervical abnormalities and the low rate of cervical cancer in this population. ACOG’s guidelines conclude that, for most healthy, low-risk adolescents who are willing and able to receive follow-up care, cervical abnormalities other than CIN 3 can be managed without therapy.

The Network has long been concerned that too many women, including adolescents, undergo unnecessary and potentially harmful treatment after a ‘bad’ Pap result. To learn more about cervical screening and Pap tests, view our fact sheet.