What to do in the event, a HSIL pap is confirmed by pathologist on re-review? After cervical biopsies have been proven to be negative, an ECC should be the next step;

If the ECC is positive, an excision (LEEP or Cone) is warranted; if the ECC is negative, follow-up with serial pap examinations (q3 months) and/or HPV in-situ studies.

If the follow-up pap smears or High Risk HPV genotypes are positive, an excision biopsy should be considered.

If the results of three serial PAP examinations are negative, and the patient is negative for HPV, no further patient follow-up is required other than standard gynecological evalutations.

For additional information, please click on the link below to view ASCCP's Consensus Algorithms.

2002, Copyright American Society for Colposcopy and Cervical Pathology
http://www.asccp.org/pdfs/consensus/algorithms.pdf