Risk of invasive cervical cancer in relation to management of abnormal Pap smear results
2009 (English)In: American Journal of Obstetrics and Gynecology, ISSN 0002-9378, E-ISSN 1097-6868, Vol. 201, no 2, 188.e1-188.e7 p.Article in journal (Refereed) Published
OBJECTIVE: We sought to evaluate the management of women with abnormal cytology in terms of subsequent risk of invasive cervical cancer.
STUDY DESIGN: The screening histories of all invasive cervical cancer cases diagnosed in Sweden 1999-2001 and of 5 population-based controls per case were reviewed. In all, 159 patients and 258 control subjects aged < 67 years had an abnormal smear result 0.5-6.5 years prior to cancer diagnosis. The cervical cancer risk was estimated in relation to management by calculating odds ratios.
RESULTS: Histologic assessment of low-grade squamous abnormalities strongly reduced the risk compared to repeated cytology (odds ratio, 0.46; 95% confidence interval, 0.24-0.89). Delaying histologic assessment was also associated with a higher risk (odds ratio, 5.65; 95% confidence interval, 1.39-23.05). After high-grade squamous atypia, absence of any cytologic or histologic specimen was a major determinant of cancer risk (odds ratio, 12.52; 95% confidence interval, 1.42-infinitive).
CONCLUSION: For adequate protection against invasive cervical cancer, further assessment with histology must be recommended also for women with low-grade squamous abnormalities.
Place, publisher, year, edition, pages
2009. Vol. 201, no 2, 188.e1-188.e7 p.
cervical cancer risk; histologic assessment; management of abnormal Pap smear results; population-based case control study; repeated cytology
IdentifiersURN: urn:nbn:se:umu:diva-37043DOI: 10.1016/j.ajog.2009.04.006PubMedID: 19560117OAI: oai:DiVA.org:umu-37043DiVA: diva2:357603