Significant outcomes associated with high-risk human papillomavirus negative Papanicolaou tests.
J Am Soc Cytopathol
; 12(3): 189-196, 2023.
Article
en En
| MEDLINE
| ID: mdl-36739194
ABSTRACT
INTRODUCTION:
The 2020 American Cancer Society guidelines preferred primary human papillomavirus (HPV) screening for cervical cancer prevention. Studies investigating the role of cytology in detection of cervical precancer/cancer have focused on high-grade squamous intraepithelial lesion (HSIL) or worse interpretations. Here, we have examined the significance of all those cytology results that require histologic follow-up as per the current management guidelines, regardless of the HPV test result. MATERIALS ANDMETHODS:
A database search (September 2010 to December 2019) retrieved cervical Papanicolaou tests with any of the following interpretations ≥ atypical squamous cells - cannot exclude HSIL or low-grade squamous intraepithelial lesion, HSIL cannot be excluded, and ≥ atypical glandular cells, not otherwise specified and its subcategories. Of these, those with concurrent negative HPV test result were included for further analysis. For this cohort, relevant clinical history and histologic follow-up (within 1 year) were recorded.RESULTS:
The study cohort comprised 763 patients. Of them, 586 (76.8%) patients had histologic follow-up 53 (9.0%) had ≥ HSIL/adenocarcinoma in situ; of which, 43 (81.1%) had prior abnormal cytology/histology/not otherwise specified history and/or HPV positivity, and 66 (11.3%) had HPV-unassociated neoplasia; of which, 60 (90.9%) had a known diagnosis or clinical signs/symptoms of the disease.CONCLUSION:
With widespread adoption of risk-based approach to management, the role of cytology, by itself, will likely diminish in the detection of HPV-associated lesions. Additional data regarding the role of cytology in the screening of patients with no/unknown/limited history and in the detection/management of HPV-independent lesions may be helpful for designing future screening guidelines.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
Problema de salud:
2_enfermedades_transmissibles
Asunto principal:
Carcinoma in Situ
/
Neoplasias del Cuello Uterino
/
Infecciones por Papillomavirus
/
Células Escamosas Atípicas del Cuello del Útero
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Risk_factors_studies
Límite:
Female
/
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Am Soc Cytopathol
Año:
2023
Tipo del documento:
Article