Frequency and Follow-Up Findings of Abnormal Cervical Cytology in Women ≥ 65 Years in a High-Risk Population
Kunle O Ojemakinde, Jaiyeola O Thomas. Louisiana State University Health Sciences Center, Shreveport, LA
Background: The 2009 ACOG guidelines for cervical screening recommend that the upper age limit for discontinuing screening be 65 or 70 years in those who have had ≥3 consecutive negative smears and no abnormal smear in the past 10 years; or have had total hysterectomy for non-cancer reason and no history of HSIL. This study reviews the abnormal cervical cytology findings in women ≥ 65 years to determine the disease burden in this age-group in a high-risk population.
Design: All abnormal cervical Pap smears (ASCUS, LSIL, ASC-H, HSIL, cancer) in women ≥ 65 years between January 2006 and June 2011 are extracted from the pathology data base and reviewed. Available follow up data of hrHPV profile, repeat cytology and histology are correlated with the abnormal findings.
Results: 145,144 Pap smears were received during the period with 5,700 (3.9%) from the target population (age range 65-89 years). 263 abnormal smears were identified from 209 women. Table 1 shows the distribution of abnormal cytology findings and corresponding biopsy/cytology follow-up. Of the 108 ASCUS index cases, 69 had HPV data with 26(37.7%) hrHPV+. Of the 13 ASCUS cases, carcinoma (3) and CIN2/3 (4) were diagnosed and invasive carcinoma in 14/48 cases (29.2%) with biopsy follow-up.
|Index Cytology(No of Cases)||Follow up Cytology||Histology||hrHPV +VE||hrHPV -VE|