<prompt> Answer this question truthfullyWhat is the best next step when a woman presents with a high-grade squamous intraepithelial lesion HSIL lesion on Pap smear?  <response>: <reason> The best next step when a woman presents with a high-grade squamous intraepithelial lesion HSIL lesion on Pap smear is immediate colposcopy or LEEP. 