Atypical Squamous Cells of Undetermined Significance in Women Over 55

Rader, Anne E.; Rose, Peter G.; Rodriguez, Michael J.; Mansbacher, Sallie; Pitlik, Deborah; Abdul‐Karim, Fadi W.

doi:10.1159/000331081

Cited by 35 publications

(10 citation statements)

References 8 publications

(16 reference statements)

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“…We found that women under 40 years are at significantly higher risk for CIN 1+ or CIN 2+ after the diagnosis BNC when compared with older women. Age has been shown to have prognostic value in other studies also 3,8,10,11,22,23,24,30,31 . Peri‐ and postmenopausal alterations such as changing hormonal levels may result in equivocal atrophic changes in older women and lead to overcalling of otherwise normal cellular changes.…”

Section: Discussionmentioning

confidence: 93%

“…Most other studies provide information on CIN or worse after a single or initial BNC smear. In these studies CIN 1+ was found in 10–46% and CIN 2+ in 1.7–14% 7,8,9,12,13,20,23,24,26,29,30 . One study, focusing on atypical squamous metaplastic cells 25 even found CIN 1+ in 62% and CIN 2+ in 44%.…”

Section: Discussionmentioning

confidence: 95%

“…In these studies CIN 1+ was found in 10-46% and CIN 2+ in 1.7-14%. 7,8,9,12,13,20,23,24,26,29,30 One study, focusing on atypical squamous metaplastic cells 25 even found CIN 1+ in 62% and CIN 2+ in 44%. Carcinoma following a borderline result was reported in only a limited number of studies and in low frequencies, ranging from 0.1% to 3.8%.…”

Section: Discussionmentioning

confidence: 99%

“…Age has been shown to have prognostic value in other studies also. 3,8,10,11,22,23,24,30,31 Peri-and postmenopausal alterations such as changing hormonal levels may result in equivocal atrophic changes in older women and lead to overcalling of otherwise normal cellular changes. Selection on age, especially of women older than 40 years of age, might prove useful in defining a subcategory of patients who are at low risk for CIN 2+ and can remain under careful cytological surveillance.…”

Section: Discussionmentioning

confidence: 99%

“… determine the compliance of GPs to refer women with repeated BNC results for colposcopy; evaluate the significance of repeated BNC by determining the detection rate of CIN 1 or worse (CIN 1+: CIN 1, CIN 2, CIN 3 and carcinoma) and CIN 2 or worse (CIN 2+: CIN 2, CIN 3 and carcinoma); investigate concurrently the value of other predictors for CIN 1+ or CIN 2+ in patients with repeated BNC Pap tests including age, 8,11,23,24 cytological type of borderline abnormality, 4,25–28 concurrent infection or inflammation (among which HPV‐associated cellular changes), 27,29,30 reported clinical symptoms and prior smear history of the patient 28 …”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Referral compliance, outcome and predictors of CIN after repeated borderline cervical smears in the Netherlands

2007

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This finding may be used for prioritizing women for colposcopy on the basis of their age. More stringent use of the diagnosis of BNC, higher thresholds for colposcopically directed biopsy and introduction of HPV triage, combined with more specific new techniques or combination of techniques such as molecular markers for P16, MIB-1 and L1 may reduce the unnecessary high referral rate and over treatment of healthy women.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Referral compliance, outcome and predictors of CIN after repeated borderline cervical smears in the Netherlands

2007

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Clinical significance of atypical glandular cells of undetermined significance in postmenopausal women

Chhieng

Elgert

Cohen

et al. 2001

Cancer

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BACKGROUND Glandular atypia in Papanicolaou (Pap) smears from postmenopausal women is encountered frequently. This finding can be the result of artifactitious alterations such as drying artifacts and inflammatory changes or may represent a squamous or glandular, preneoplastic or neoplastic process. Therefore, it is important to determine the clinical implication of a diagnosis of atypical glandular cells of undetermined significance (AGUS) in postmenopausal patients. METHODS A total of 30,036 Pap smears were obtained from postmenopausal women between 1995 and 1997. Among these smears, 154 (0.51%) had a diagnosis of AGUS. Follow‐up was available for 133 patients (86.4%); 110 patients (82.7%) had histologic follow‐up (including cervical biopsy, endocervical [EC] curettage, and/or endometrial [EM] biopsy) and 23 patients (17.3%) had repeat smears. RESULTS Thirty‐six of 110 patients (32.7%) were found to have a clinically significant lesion (defined as a preneoplastic or neoplastic, glandular or squamous lesion) on subsequent histologic follow‐up. Nineteen patients (53%) had glandular lesions (15 EM adenocarcinoma [ACA] cases, 2 EC ACA cases, 1 EC adenocarcinoma is situ case, and 1 EM hyperplasia case). Seventeen patients (47%) had a squamous intraepithelial lesion (SIL) (6 cases of low‐grade SIL, 9 cases of high‐grade [HGIL], and 2 cases of squamous cell carcinoma). Among those patients with repeat Pap smears, five patients had persistent AGUS/atypical squamous cells of undetermined significance and one patient had an SIL. CONCLUSIONS The incidence of AGUS among postmenopausal patients was similar to that of the general population (0.51% vs. 0.56%; P > 0.05). A significant percentage of these patients were found to have a clinically significant lesion on subsequent follow‐up. Furthermore, a majority of these lesions were ACA (53%) or HGSIL (26%). The findings of the current study strongly suggest the need for the close follow‐up of postmenopausal patients with a diagnosis of AGUS. Cancer (Cancer Cytopathol) 2001;93:1–7. © 2001 American Cancer Society.

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Diagnosis of ?ASCUS? in women over age 50 is less likely to be associated with dysplasia

Flynn

Rimm

2001

Diagn. Cytopathol.

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Atypical Squamous Cells of Undetermined Significance in Women Over 55

Cited by 35 publications

References 8 publications

Referral compliance, outcome and predictors of CIN after repeated borderline cervical smears in the Netherlands

Referral compliance, outcome and predictors of CIN after repeated borderline cervical smears in the Netherlands

Clinical significance of atypical glandular cells of undetermined significance in postmenopausal women

Diagnosis of ?ASCUS? in women over age 50 is less likely to be associated with dysplasia

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