{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T08:19:01Z","timestamp":1778573941648,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2013,6,13]],"date-time":"2013-06-13T00:00:00Z","timestamp":1371081600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Cervical cytology is the cervical cancer screening test for women aged &lt;30 years because of the low specificity of human papillomavirus tests in this age group. The Bethesda System classifies cervical intraepithelial neoplasia grade 2 (CIN 2) and grade 3 (CIN 3) as high\u2010grade intraepithelial lesions (HSIL). In this study, the authors subclassified cytologic HSIL as suggestive of CIN 2 (HSIL\u2010CIN 2) or CIN 3 (HSIL\u2010CIN 3) and evaluated whether there was a correlation between these findings and age for screened and unscreened women.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The study included 2,002,472 cervical smears collected from women who had at least 1 previous test (screened) and 217,826 previously untested women (unscreened). The laboratory has been using the Bethesda System since 1998 with the subcategorization of HSIL\u2010CIN 2 and HSIL\u2010CIN 3.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>For unscreened women, the prevalence of low\u2010grade intraepithelial lesion (LSIL) and HSIL\u2010CIN 2 decreased with age, whereas the prevalence of HSIL\u2010CIN 3 increased. The prevalence of HSIL\u2010CIN 2 was greater than that of HSIL\u2010CIN 3 for women up to age 29 years (prevalence ratio [PR], 4.73; 95% confidence interval [CI],  3.90\u20105.75) and lower for the groups ages 30 to 49 years (PR, 0.66; 95% CI, 0.50\u20100.87) and \u226550 years (PR, 0.21; 95% CI, 0.12\u20100.36). For screened women, the prevalence of HSIL\u2010CIN 2 also was greater in the group aged \u226429 years (PR, 2.72; 95% CI, 2.49\u20102.97).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The prevalence pattern of HSIL suggestive of CIN 2 resembled the pattern observed in LSIL and was more prevalent than HSIL suggestive of CIN 3 in younger women. The impact of screening was less evident when HSIL was suggestive of CIN 2. A conservative approach for younger women who have HSIL is important for management guidance. Cancer (Cancer Cytopathol) 2013;121:576\u2013581. \u00a9 2013 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.21312","type":"journal-article","created":{"date-parts":[[2013,6,13]],"date-time":"2013-06-13T12:24:40Z","timestamp":1371126280000},"page":"576-581","source":"Crossref","is-referenced-by-count":13,"title":["High\u2010grade squamous intraepithelial lesion in women aged &lt;30 years has a prevalence pattern resembling low\u2010grade squamous intraepithelial lesion"],"prefix":"10.1002","volume":"121","author":[{"given":"Diama B.","family":"Vale","sequence":"first","affiliation":[{"name":"School of Medicine Rondonia Federal University Rondonia Brazil"},{"name":"School of Medicine Campinas State University Campinas Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria C.","family":"Westin","sequence":"additional","affiliation":[{"name":"School of Medicine Campinas State University Campinas Brazil"},{"name":"Dr. Jose Aristodemos Pinotti Women's Hospital Campinas State University Campinas Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luiz C.","family":"Zeferino","sequence":"additional","affiliation":[{"name":"School of Medicine Campinas State University Campinas Brazil"},{"name":"Dr. Jose Aristodemos Pinotti Women's Hospital Campinas State University Campinas Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,6,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.16.2114"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2010.01.002"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.25635"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0b013e3181cec411"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djq356"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2303.2010.00819.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22425"},{"key":"e_1_2_7_9_1","first-page":"2012","article-title":"Role of protein biomarkers in the detection of high\u2010grade disease in cervical cancer screening programs [serial online]","volume":"289315","author":"Brown CA","year":"2012","journal-title":"J Oncol"},{"key":"e_1_2_7_10_1","first-page":"2012","article-title":"Biomarkers of cervical dysplasia and carcinoma [serial online]","volume":"507286","author":"Hwang SJ","year":"2012","journal-title":"J Oncol"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1743-422X-9-262"},{"key":"e_1_2_7_12_1","first-page":"S21","article-title":"Observer variation, dysplasia grading, and HPV typing: a review","volume":"114","author":"Llewellyn H","year":"2000","journal-title":"Am J Clin Pathol."},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004347-200301000-00003"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2012.10.087"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a1284"},{"key":"e_1_2_7_16_1","unstructured":"Instituto Nacional de Cancer.Diretrizes brasileiras para o rastreamento do cancer do colo do utero. 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