Prevalence Of Significant Lesions Research Articles

Is Age an Independent Predictor of High-Grade Histopathology in Women Referred for Colposcopy after Abnormal Cervical Cytology?

This study was conducted to determine whether advancing age is an independent predictor of increased risk of high-grade pathologies among women referred for colposcopy after abnormal cervical cytology. Medical records were reviewed for women with abnormal cervical cytology who underwent colposcopy at Khon Kaen University Hospital. Logistic regression was used to determine the independent impact of age on the risk of high-grade pathologies. Mean age of the women was 42.8 years. Of 482 women, 97 (20.1%) were postmenopausal, and 92 (19.1%) were nulliparous. The rate of high-grade pathologies included cervical intraepithelial neoplasia 2-3, 99 (20.5%), adenocarcinoma in situ, 4 (0.8%), cervical cancer, 30 (6.2%), and endometrial cancer, 1 (0.2%). The prevalence of significant lesions was 26.9% (95% CI, 23.1%-31.2%). In total, 31 women had cancers (6.4%; 95% CI, 4.4%-9.0%). When controlling for smear types and parity, age was noted to be a significant independent predictor of high-grade histopathology. Women older than 35-40 years were approximately 2 times as likely to have severe histopathology as the younger women. This study illustrates the substantial risk of underlying significant lesions especially invasive cancer in Thai women with abnormal cervical cytology. Age was a significant independent factor predicting the risk of high-grade pathologies.

Cervical pathology in high-risk human papillomavirus- positive, cytologically normal women.

This study was undertaken to evaluate the prevalence of significant cervical pathology among women who are high-risk human papillomavirus (HR-HPV)-positive/cytology negative, the most common combination of positive co-tests. The records of 244 women HR-HPV-positive/cytology-negative who had undergone colposcopy at Srinagarind Hospital, Khon Kaen University during January 2010 and April 2014 were reviewed. Mean age was 46.4 years. Of these 224 women, 75 were positive for HPV types 16/18 (33.5%) and 123 were positive for non-16/18 types (54.9%). HR-HPV was not genotyped in the remaining 26 women (11.6%). Prevalence of significant lesions for the entire cohort was 2.4%, and 2.6% and 3.3%, respectively, for those with HPV 16/18 and other oncogenic HPV types. One woman with HPV 16/18 (1.3%) had invasive cervical cancer. Multiparous women were more likely to be infected with HPV 16/18 compared to nulliparous women (36.3% versus 17.6%, respectively). In conclusion, the prevalence of significant cervical lesion among our study population was 2.4%. Multiparous women were more likely to be infected with HPV 16/18 compared to nulliparous women.

Tu1518 Total Colonoscopy for Positive Fecal Occult Blood Test: Could It Be Replaced With Sigmoidoscopy?

(9) (pZ0.06; OR, 1.8; 95%CI 1-3.3). IBD was most likely to be diagnosed in patients younger than 40 years, 83.3% (10) vs. 16.3% (2) (pZ0.003; OR, 3.6; 95%CI 1.1-12.8). CRC was more frequent over 40; 72% (10) vs. 28% (4) (pZ0.6; OR, 1.3; 95%CI, 0.8-2.9), as well as adenomatous polyps who were also more common in this age group; 70.4% (69) vs. 29.6% (28) (pZ0.0.2; OR, 1.8; 95%CI: 1.1-2.9). Conclusion: We found a high prevalence of significant lesions (20.8%), especially adenomatous polyps and CRC, who combined for 18.8% (16.4% and 2.4% respectively). These lesions were more common in patients older than 40 years, mainly distal to the splenic flexure. This would suggest that these lesions could have been diagnosed by a sigmoidoscopy. Despite this and given the high prevalence of adenomatous polyps and CRC found in patients over 40, is that we believe that colonoscopy should be recommended in this age group. Table 1. Lesions found on colonoscopy

Rectal bleeding in adults over 20 years: Endoscopic investigations and results in current hospital practices in Yaoundé, Cameroon

Introduction: In order to identify the modes of investigation and the results of the assessment of rectal bleeding in the Cameroonian adult, we retrospectively analysed the records of 287 patients aged above 20 years diagnosed with rectal bleeding with the aim to know the prescription patterns according to age, the diagnostic performance of tests and the results. Methodology: Between the 1st of January 2009 and the 30th of June 2010, we examined patients at the University Teaching Hospital and the “La Cathédrale” Medical Centre in Yaounde. Age, sex, endoscopic tests and results were evaluated. Results: 287 protocols met our selection criteria, sex ratio (M/F) 2.4/1, median age 46 years interquartile range [36, 55]. Normal tests were 57 (19.2%). Main lesions: haemorrhoids (42.4% CI95 36.7 -48.3), colorectal cancer (10.8% CI95 7.5 -14.9), anal fissure (8.8% CI95 5.8 -12.6) and colorectal polyps (8.4% CI95 5.5 -12.2). The prevalence of significant lesions (polyps and cancer) recorded 7% for those under age 40. 20.5% in those were between 40 -50 years, and 28.9% for those over 50 years. For anoscopies, 44.4% were under 40 years, 39.3% of cases of sigmoidoscopy affected those between 40 -50 years and colonoscopy affected 54% of those over 50 years. For the diagnostic yield, 26.2% had a significant lesion for flexible sigmoidoscopy and only 16.7% and 1.6% for colonoscopy and anoscopy respectively. Conclusion: The study shows that anoscopy and sigmoidoscopy are the main initial tests conducted in Cameroon in the assessment of rectal bleeding in adults of less than 50 years and they are quite sufficient. Haemorrhoids and colorectal cancer are the main pathologies.

Clinical significance of atypical glandular cells on Pap smears: Experience from a region with a high incidence of cervical cancer

To evaluate the histopathology of women who had atypical glandular cells (AGC) on Pap smears in a region with high incidence of cervical cancer. This study was conducted at Chiang Mai University Hospital, Chiang Mai, Thailand. All women with AGC who underwent colposcopic and histopathologic evaluation between January 2002 and December 2008 were reviewed. Women with simultaneous diagnosis of squamous cell abnormality or prior history of cancer of any type were excluded. Sixty-three women with AGC Pap test had histologic follow-up during the study period. Mean age was 44.9 years (range, 31-72 years). Six (9.5%) women were nulliparous. Sixteen (25.4%) women were postmenopausal. The histopathologic results of these 63 women were as follows: cervical intraepithelial neoplasia (CIN) 2-3, 5 (7.9%); adenocarcinoma in situ (AIS), 3 (4.8%); endometrial cancer, 3 (4.8%); cervical cancer, 2 (3.2%); endometrial hyperplasia (EH), 1 (1.6%); and no lesions, 49 (77.8%). The prevalence of significant lesions (CIN 2-3, AIS, EH, and cancer) in women with atypical glandular cells, favor neoplasia (AGC-FN) was significantly higher than that in the atypical glandular cells, not other specified (AGC-NOS) group (41.2% and 15.2%, P = 0.02). Reporting AGC in our population is clinically significant due to the high prevalence of underlying preinvasive and invasive diseases (22.2%). This subtype of the AGC category is a significant predictor of such lesions.