Smear biopsies: a cause of negative follow-up biopsies in patients with premalignant conditions of the uterine cervix.

The cervical scrape technique used in diagnostic cytology may strip off epithelial sheets larger than 0.5 mm. We call them smear biopsies. We followed with cytological, histopathological and clinical examinations 28 nonpregnant women whose smear biopsies showed severe dysplasia or carcinoma in situ. All of them were followed for at least 4 years. In only two of them was atypical epithelium discovered. Our study shows that a cervical scraping may result in negative follow-up histology due to removal of all premalignant epithelium. The cytology findings in these cases should not be considered wrong by either the histopathologists or the clinicans, and the patient should be followed closely with cytological smears to detect recurrences or progression to carcinoma at an early stage.