Objective-To assess correlation between nonspecific cervicitis, inflammation, or Conclusion-Reports of inflammatory changes on cervical smear testing are a poor indicator of infection.
IntroductionMost laboratories reporting results of cervical smear tests comment on the possible presence of infection based on cytological criteria. Thus it is common to get a cervical smear report of non-specific cervicitis or inflammatory changes. The importance of these findings is unknown and no guidelines exist on appropriate management. Thus family doctors are often faced with the questions, should these women be recalled for cultures or treatment and are these women more likely to have positive cultures than women without inflammatory changes reported on smear testing?This prompted one of us (WP) to recall for cervical cultures all women with reports of non-specific cervicitis on smear testing. This study determined that 40% of women with non-specific cervicitis on cervical smear tests had a positive culture for some organism. Kelly and Black in a study of a general practice found that 47% of women with inflammatory changes on cervical smear testing had a microbiologically proved
on behalf of the British Co-operative Clinical GroupObjectives: To determine the current practice of smear taking in sexually transmitted infection (STI) clinics within the United Kingdom; what proportion of smears are taken within the national guidelines; whether clinics are screening women not covered by the national screening programme. To compare the abnormality rates of routine and opportunistic (that is, in addition to the screening recommendations) smears; the abnormality rates of smears taken within STI clinics with those taken within the community setting. Methods: A questionnaire was circulated to all clinics in May 1998. Details of screening practice were requested. The clinics then prospectively collected details of patient's age, GP registration, date and result of previous smear, and current result of all smears taken between 11 May 1998 and 25 May 1998. Results: There were 1828 smears taken in the 2 week period; 504 (27.6%) were opportunistic. Opportunistic smears had marginal significantly increased rates of low grade abnormalities but lower (but not statistically significant) high grade abnormalities than in routine smears. 231 (12.6%) of the women were not registered with a GP so would not be included in the national programme. The national rates of abnormalities were significantly higher in the STI clinics compared with the community setting.
Conclusion:The majority of smears taken within STI clinics fall within the national guidelines, and 12.6% of the women would probably not otherwise have been screened. The rates of abnormality were significantly higher in the STI clinics but smears taken opportunistically were less likely to have high grade abnormalities. There is no evidence from this study to support the practice of additional smears in the presence of an eVective national cytology screening programme. (Sex Transm Inf 2001;77:107-110)
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