Risk of invasive cervical cancer in relation to management of abnormal Pap smear results

Lena Silfverdal, Levent Kemetli, Bengt Andrae, Par Sparen, Walter Ryd, Joakim Dillner, Bjorn Strander, Sven Tornberg

Research output: Contribution to journalArticlepeer-review

9 Citations (SciVal)

Abstract

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.
Original languageEnglish
JournalAmerican Journal of Obstetrics and Gynecology
Volume201
Issue number2
DOIs
Publication statusPublished - 2009

Subject classification (UKÄ)

  • Obstetrics, Gynecology and Reproductive Medicine

Keywords

  • population-based case control study
  • smear results
  • repeated cytology
  • management of abnormal Pap
  • cervical cancer risk
  • histologic assessment

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