The significance of moderate and severe inflammation on class I Papanicolaou smear The significance of a cytologic diagnosis of moderate and severe inflammation with a normal (class I) Papanicolaou smear has not been addressed. A retrospective review of 596 consecutive cervical smears performed over 13 months revealed 85 women who had a class I cytologic smear with moderate to severe inflammation. Seventy-eight patients had colposcopic examinations and were considered for this study. Fifty-nine (75.6%) had cervical punch biopsies and/or endocervical biopsies. Of the 78, 19 (24.4%) had cervical condylomata and nine (11.5%) had cervical intraepithelial neoplasia. We conclude that class I cytologic smears with moderate to severe inflammation may be associated with findings of condylomata and cervical dysplasia. 