Final answer:
When a patient has a negative colposcopy with significantly abnormal cytology smear, the recommended next step is to repeat the cytology in 6 months. If the repeat cytology continues to show significant abnormalities, further diagnostic procedures like a cone biopsy may be considered.
Step-by-step explanation:
When a patient has a negative colposcopy with significantly abnormal cytology smear, it means that there are no visible abnormalities on the surface of the cervix, but the cells analyzed under a microscope show significant abnormalities. In this case, the recommended next step is to repeat the cytology in 6 months. This is done to monitor any changes in the abnormal cells over time. If the repeat cytology continues to show significant abnormalities, further diagnostic procedures like a cone biopsy may be considered.