Should High-Risk Adolescents Have Pap Tests?
Ly T Ma, Gwyn Richardson, Reagan M Street, Vicki J Schnadig. University of Texas Medical Branch, Galveston, TX
Background: The 2009 ACOG guidelines state that cervical cancer screening (CCS) commence at age 21-years owing to a very low incidence of cervical carcinoma in this age group and the potential for harmful follow-up treatment. Our institution serves a large population of high-risk adolescents (HRA), with early onset of sexual activity and pregnancies. We investigated outcomes and demographic data of HRA with HSIL Pap tests in order to identify any subgroups who may benefit from CCS.
Design: Computer-based search for years 2000-10 was done to identify Pap results from women under 21-years-old. Chart review of women with at least one HSIL Pap test was done to obtain biopsy and LEEP results and sexual and pregnancy history when available.
Results: Of 56,785 adolescent Pap tests, 45,276 (79.5%) were negative, 11,232 (20%) were ASCUS or LSIL and 277 (0.5%) were HSIL; Of the HSIL group, 89 (32%) had no biopsy, 35 (13%) had no dysplasia on biopsy, 57 (21%) had CIN 1, 40 (14%) had CIN 2, and 56 (20%) had CIN 3. One case of microinvasive cervical carcinoma (MIC) was found on LEEP.
|Grade||No. Lifetime Partners (n)||Age of First Intercourse (n)||Age of First Pregnancy (n)|
|CIN 1/No Dysplasia on Bx||3 (9)||16 (8)||18 (6)|
|CIN 2||4 (10)||18 (11)||18 (6)|
|CIN 3/MIC||7 (14)||15 (15)||17 (9)|