Cervical Papanicolaou Smear Abnormalities and Chlamydia Trachomatis in Sexually Active Adolescent Females

Abstract

Study Objective: To examine the effect of cervical Chlamydia trachomatis infection on the prevalence of Papanicolaou (Pap) smear abnormalities in adolescent females.Design: Retrospective study performed by examination of previously obtained cervical C. trachomatis cultures and Pap smear results.Setting: Urban adolescent health care clinic in the Bronx, New York.Participants: Sexually active females, aged 13 to 23 (mean age: 17.9 years), attending the clinic for evaluation of sexually transmitted diseases.Intervention: Patients who had undergone a gynecological examination with performance of cervical Pap smears and culture for C. trachomatis were enrolled in the study.Main Outcome Measure: Determine the prevalence of cervical C. trachomatis infection and compare cervical smear abnormalities in those with and without infection.Results: Of a study population of 257 females, 24 patients (9.3%) were culture positive for C. trachomatis and 58 patients (22.6%) had significant cervical smear abnormalities, i.e., atypical squamous cells of undetermined significance (ASCUS), low grade squamous intraepithelial lesion (LGSIL), or high grade squamous intraepithelial lesion (HGSIL). The 24 patients infected with C. trachomatis showed the following cervical smear abnormalities: within normal limits—37.5%, benign cellular changes—41.7%, ASCUS—12.5%, and LGSIL—8.3%. A total of 233 patients (90.7%) were culture negative for C. trachomatis and showed the following cervical smear abnormalities: within normal limits—37.3%, benign cellular changes—39.9%, ASCUS—13.3%, LGSIL—8.6%, and HGSIL—.9%. Statistical analysis suggested no significant differences between the two groups (P > .9 by the Kruskal-Wallace test).Conclusions: The isolation of C. trachomatis from the cervix of sexually active adolescent females at a single point in time does not impact on the prevalence of significant cervical smear abnormalities.