Managing low-grade cervical lesions
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* Robert Burn

In their article on management of LSIL in young women, Susie Lau and Eduardo Franco have provided an algorithm that if implemented would reduce unnecessary intervention and anxiety in women aged 24 years or less.1 However, as they state, the incidence of invasive cervical cancer in women aged 20–24 years is 1.7 per 100 000 annually, far below the incidence of HIV seropositivity (16–34 per 100 000 in young women2) and diseases such as lymphoma (12.5 per 100 000 in people of all ages3), for which we do not routinely screen. Is there evidence that detection of cervical cytological abnormalities in this group reduces the risk of developing cervical cancer later? If not, it is illogical to recommend screening for women younger than 24 years of age.

## REFERENCE

1.  1.  Lau S, Franco SL. Management of low-grade cervical lesions in young women. CMAJ 2005;173(7):771-4.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czo5OiIxNzMvNy83NzEiO3M6NDoiYXRvbSI7czoyMjoiL2NtYWovMTc0LzYvODEzLjIuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9) 

2.  2. Inventory of HIV incidence and prevalence studies in Canada. Ottawa: Health Canada; 2004. Available: [www.phac-aspc.gc.ca/publicat/hips-ipvc04/](http://www.phac-aspc.gc.ca/publicat/hips-ipvc04/) (accessed 2005 Nov 10).
    
    

3.  3. *Harrison's principles of internal medicine*. 12th ed. New York: McGraw-Hill; 1991.