Colposcopic and Histological Outcome of Atypical Squamous Cells of Undetermined Significance and Atypical Squamous Cell of Undetermined Significance Cannot Exclude High-Grade in Women Screened for Cervical Cancer.

Osman Ortashi,Dana Abdalla

doi:10.31557/apjcp.2019.20.9.2579

Abstract

Objectives:The objectives of the study are to assess the prevalence of colposcopic and histological abnormalities in patients diagnosed with ASCUS and ASC-H and to compare the prevalence of CIN in each group. Methods:Population-based cross-sectional retrospective study was conducted in one of tertiary hospitals in UAE. All cervical smears reported as ASCUS or ASC-H in 2015 were included in this study. The local guideline in 2015 was to refer all cases of ASC for colposcopy assessment. Results:Overall 7,418 cervical smears were processed at our laboratory service, 5.6% (n=413) were reported as ASC. 95% of them (n=394) were ASCUS and 5% (n=19) were ASC-H. The overall prevalence of high grade CIN in patients with ASC-H is 26% compared with 0.8% for patients with ASCUS regardless the age. The relative risk of patients with ASC-H is 8 folds higher than patients with ASCUS to have low grade CIN but 29 fold higher risk of having High grade CIN and the P value =0.0001.Conclusion:ASC-H cytology confers a substantially higher risk for high grade CIN than ASCUS regardless of age. HPV test is an important triage test in patients with ASCUS to predict cellular changes and CIN.

Highlights

Organized cervical cancer screening has been proved to be one of the most successful cancer prevention strategies
The objectives of the study are to assess the prevalence of colposcopic and histological abnormalities in patients diagnosed with ASCUS and atypical squamous cells (ASC)-H and to compare the prevalence of CIN in each group
The overall prevalence of high grade CIN in patients with ASC-H is 26% compared with 0.8% for patients with ASCUS regardless the age

Summary

Introduction

Organized cervical cancer screening has been proved to be one of the most successful cancer prevention strategies. Countries with established organized cervical cancer screening programs witnessed significant reduction in the incidence of cervical cancer of approximately 70%. Cervical smear or (Pap smear) smear is the standard screening test for cervical cancer and cervical dysplasia (Tambouret, 2013). The test was developed by Georgios Papanikolaou in 1941. The cervical smear test is based on collection of cells from the cervix and vagina and to detect cellular abnormalities that arise mainly from the transformation zone where almost all cervical dysplasia and cancers arise. The cervical smear which is screening test yields cytological result but not histological diagnosis

Objectives

Methods

Results