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Exceptions to this guideline are sexually active adolescents with human immunodeficiency virus (HIV) and those who are otherwise immunocompromised.[1] In current practice, many adolescents continue to have Papanicolaou (Pap) tests, and those with high-grade squamous intraepithelial lesions (HSIL) are referred for colposcopy and biopsy; and biopsy has been recommended for adolescents with persistent HSIL. Adolescents with biopsy-confirmed CIN-2 may be managed by observation with colposcopy and cytology. Neither the risk for progression of CIN-3 nor the recommended follow-up and treatment of CIN-3 in adolescents has been established. Excisional procedure has been recommended for adolescents who have biopsy-confirmed http://www.selleck.cn/products/ipi-145-ink1197.html CIN-3.[4] Conservative follow-up with Pap and colposcopy also may be an option given the rarity of invasive carcinoma in adolescents. The most recent guidelines obviate the associated angst regarding adolescent HSIL therapy by recommending that women aged http://www.selleckchem.com/products/SB-431542.html of cervical cancer in this group.[5] There is special concern about the potential for harmful follow-up treatment of abnormal Pap test results, including the risk of preterm delivery, preterm labor, and premature rupture of membranes.[6] Although the ACOG recommendation to delay screening until age 21 years seems valid based on the very low incidence of ICC in adolescents, a small number of persistent CIN-3 lesions will go undetected, and guidelines suggest that there will be ��catch-up�� detection of these HSIL after the initiation of screening at age 21 years. CIN-3 has been identified by biopsy in 7% to 8% of adolescents who were referred for colposcopy.[7, 8] Because the natural history of CIN-3 is unknown, the potential risks of allowing CIN-3 to remain undetected in adolescent women may continue to cause anxiety http://www.selleckchem.com/products/byl719.html among health care professionals, at least until adequate data are acquired to confirm a high benefit-to-harm ratio and initiation of screening at age 21 years becomes the accepted norm. Our institution serves a large population of sexually active adolescents with a high rate of teenage pregnancies. Until recently, these young women have undergone routine Pap screening. The objective of the current study was to determine whether there is a subgroup of adolescent girls who may benefit from Pap screening before age 21 years.