Objective: To evaluate clinical predictors of cervical intraepithelial neoplasia (CIN) 2 or greater in women with mildly abnormal Pap smears.
Study design: Using a computerized colposcopy database of 2,200 women, we identified 1,494 with atypical squamous cells of undetermined significance (ASCUS) or low grade squamous intraepithelial lesions (LSILs). Of the 1,494, 1,016 (68%) underwent biopsy and formed the cohort for this retrospective review. Clinical variables associated with CIN 2 or greater in a univariate analysis (P < .10) were included in a multivariate regression analysis.
Results: Of the 1,016 women biopsied, 195 (19%) had CIN 2 or greater. In the initial analysis, age (< 35 years), race (Caucasian and African American), marital status (unmarried) and smoking status (current and former) were found to be significantly associated with more severe histologic disease. In the regression analysis, a history of smoking remained a statistically significant clinical predictor of CIN 2 or greater (odds ratio 1.57, 95% confidence intervals 1.09-2.27).
Conclusion: A significant predictor of CIN 2 or greater in a large cohort of women with mildly abnormal Pap smears was a history of current or former smoking.