Re: Management of women with low-grade cytology: How reassuring is a normal colposcopy examination?

The debate over best management of low-grade smear results is still open. The Italian Society of Colposcopy and Cervico-Vaginal Pathology, in the Guidelines on the Management of Women with Abnormal Cervical Cytology stated that women with low-grade cytological abnormalities should be immediately referred for colposcopic examination in an outpatient clinic.This option was criticised because it may lead to overtreatment, complications and later adverse effects in young women, without clear psychological benefit. One suggestion that we could make is to restrict the use of a see-and-treat approach since the two-step approach, requiring a colposcopically obtained direct biopsy, as recently recommended by the Society of Obstetricians and Gynecologists of Canada, is, in our opinion, preferable and favours a better training for colposcopist.