Diagnosis of high-grade squamous abnormalities

Background

HSIL may be suspected from the cytological examination of cells from a cervical smear or LBC preparation. However, in Australia it has been considered best practice to establish the final diagnosis on histopathological examination of tissue obtained from cervical punch biopsy or an excisional procedure. 

Histological diagnosis of HSIL (CIN2/3) is necessary before proceeding to treatment, except in certain circumstances. Treatment undertaken at the time of initial colposcopic assessment is known as ‘treatment at first visit’ or ‘see-and-treat’ (see Treatment at first visit in Chapter 7. Colposcopy).

Recommendation

Consensus-based recommendation*

REC10.1: Histological diagnosis prior to treatment For women who have a visible lesion at colposcopy, histological confirmation of HSIL is recommended before undertaking definitive treatment.

Author(s):

• A/Professor Lyndal Anderson — Co-author
• A/Professor Selvan Pather — Co-author
• Professor Gordon Wright — Co-author
• Professor Ian Hammond — Co-author
• Professor Marion Saville — Co-author
• Cancer Council Australia Cervical Cancer Screening Guidelines Working Party — Co-author

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