If HSIL is found on a pap smear, what is the next step?

When high-grade squamous intraepithelial lesions (HSIL) are detected on a Pap smear, the recommended next step is to perform colposcopy with biopsy. This approach is important because HSIL indicates a significant risk for cervical cancer; therefore, immediate further evaluation is essential.

Colposcopy allows for a detailed examination of the cervix, which can reveal areas of concern that may not be visible during a standard pelvic examination. During this procedure, if suspicious lesions are identified, a biopsy can be taken to assess for the presence of cervical dysplasia or cancer. This two-step analysis is crucial for accurate diagnosis and for determining the appropriate management plan, which may include monitoring, further treatment, or more invasive procedures, depending on biopsy results.

The other options, such as taking a wait-and-see approach or scheduling a repeat Pap smear, would not provide the necessary information to manage a potentially serious issue promptly. Direct treatment without further testing could also lead to overtreatment or insufficient treatment, depending on the findings. Therefore, performing colposcopy and biopsy is the best practice to ensure proper diagnosis and follow-up care in cases of HSIL findings.