Abnormal cervical cytology in sexually active adolescents.

A routine Pap smear was performed on 1,207 sexually active adolescents seen in a public health department family planning clinic. One hundred and thirty-two (11%) had abnormal findings and were referred for evaluation to the gynecologist of their choice. Thirty-five patients (27%) failed to keep their initial referral appointment, and twenty-eight patients (21%) were inadequately evaluated. Therefore, only 69 patients (52%) were evaluated by colposcopy with directed biopsies. Fifty of the 69 patients (72%) had cervical intraepithelial neoplasia. Sexually active adolescents should be routinely screened with Pap smears and those with abnormal findings should be evaluated and a tissue diagnosis obtained. The primary care provider must reinforce the need for complete evaluation and therapy. Referral must be made to a gynecologist who is expert in the evaluation of abnormal Pap smears.