Cervical dysplasia and human papillomavirus: Evaluation in an adolescent dysplasia clinic

Hillard, Paula J. Adams; Biro, Frank M.; Wildey, Linda S.; Bradley, Jennifer; Burket, Robert L.; Rauh, Joseph L.

doi:10.1016/s0932-8610(89)80031-3

Cited by 12 publications

(2 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The LGSIL rate of 7.7% (91% of cases with SIL) in the current study was significantly higher than that observed for the female population at large. The LGSIL rate at specialty adolescent dysplasia referral clinics has been variably reported to be 42%,17 62%,18 and 90%19 of dysplastic smears. Debate has recently surfaced in the literature as to whether adolescent Pap smears are even necessary, because LGSIL predominates and the likelihood of progression to carcinoma is unlikely before age 20 years 20.…”

Section: Discussionmentioning

confidence: 99%

Cervical Papanicolaou smear abnormalities in inner city Bronx adolescents

Edelman¹,

Fox²,

Alderman³

et al. 1999

Cancer

View full text Add to dashboard Cite

BACKGROUND The aim of this study was to quantify the prevalence of cervical smear abnormalities in sexually active adolescents and identify the effect of immune‐modifying conditions. METHODS Two hundred seventy‐one females ages 13–22 years attending a clinic for sexually transmitted disease (STD) evaluation had cervical Papanicoloau (Pap) smears and completed sexual history questionnaires. Results of all follow‐up Pap smears were obtained. Medical charts were available for 54 patients with cytologic follow‐up and were reviewed for the presence of immune‐modifying conditions. Follow‐up smear results for patients with and without immune‐modifying conditions were compared. Abnormality rates for all cervical smears seen in 1995 at Montefiore Medical Center were also obtained. RESULTS The smear abnormality rate for adolescents was 20.7% (abnormal squamous cells of undetermined significance [ASCUS], 12.2%; low grade squamous intraepithelial lesion [LGSIL], 7.7%; high grade squamous intraepithelial lesion [HGSIL], 0.7%) compared with all adult females, for whom the rate was 13.2% (ASCUS, 9.9%; LGSIL, 2.5%; HGSIL, 0.6%; carcinoma 0.2%) (P < 0.0002). Of 20 initial ASCUS patients, 6 (30%) showed LGSIL or HGSIL on follow‐up. Chart review allowed the clinical immune status of 54 patients to be determined. Of 14 patients with an immune‐modifying condition (9 HIV positive patients, 3 receiving oral steroids, 1 liver transplant patient receiving steroids, and 1 with intestinal lymphangiectasia), 11 (78.6%) developed or maintained an abnormality on cytologic follow‐up. Of 40 patients with no identifiable immune‐modifying condition, 11 (27.5%) developed or maintained an abnormality on cytologic follow‐up (P < 0.00082). CONCLUSIONS Sexually active adolescents are at higher risk of developing a significant cervical smear abnormality, especially LGSIL. Patients with an atypical Pap smear or immune‐modifying condition require more attentive gynecologic monitoring. Cancer (Cancer Cytopathol) 1999;87:184–9. © 1999 American Cancer Society.

show abstract

Section: Discussionmentioning

confidence: 99%

Cervical Papanicolaou smear abnormalities in inner city Bronx adolescents

Edelman¹,

Fox²,

Alderman³

et al. 1999

Cancer

View full text Add to dashboard Cite

show abstract

“…S everal authors have shown that the risk of highgrade cervical intraepithelial neoplasia (CIN) is substantial among females with abnormal cervical cytology, ranging from 8% to 50% [1][2][3][4][5]. However, few of these articles stratified risk by age or by the grade of referral cytology using terminology from the Bethesda system for classification.…”

mentioning

confidence: 99%