Premalignant lesions of the uterine cervix in a large cohort of Israeli Jewish women

Abstract

Israeli Jewish women are at low risk for cancer of the uterine cervix. In view of absent screening programs in Israel, there are only scarce data available with regard to results of PAP smears. The aim of this study was to assess the incidence of premalignant cervical lesions in the largest sample of PAP smears reported so far from Israel. We retrospectively analyzed the results of 297,849 PAP smears, which had been examined in a single laboratory, during 9 years (1991-1999). The incidence of low- and high-grade squamous intraepithelial was 0.69% and 0.29%, respectively. Our data indicate similar incidence rates for premalignant lesions in Jewish Israeli women as observed in Western countries, but no increase during the study period. In spite of relatively high incidence rates for premalignant lesions of the uterine cervix, the incidence rate for invasive cervical cancer remains conspicuously low. For unknown reason the conversion rate from premalignant cervical lesions to invasive cancer is lower in Israeli Jewish women than in European and North American women. We discuss possible reasons for this phenomenon and suggest that at this time mass screening for cervical cancer in Israel may probably not be justified.

Clinical evaluation of atypical glandular cells of undetermined significance upon cervical cytologic examination in Israeli Jewish women

“…Cervical carcinoma ranks 20th among all their cancers, with the adjusted incidence rate being B5 out of 100 000, a figure among the lowest worldwide. The data recently published by Sadan et al (2003) now indicate similar incidence rates for premalignant lesions in Jewish Israeli women as observed in Western countries. The current study was undertaken to evaluate the efficacy of follow-up methods and the nature of the results of atypical glandular cells of undetermined significance (AGUS) detected on cervical Pap smears in this unique population.…”

“…Sadan et al (2003) retrospectively analysed the results of 297 849 Pap smears during 9 years (1991 -1999), and their data indicated similar incidence rates for premalignant lesions in Jewish Israeli women as observed in Western countries. Bar-Am et al (1995) found that the prevalence of abnormal cytology among the Israeli women was almost the same as that of a non-Jewish group (24 out of 1000 and 26 out of 1000, respectively), and that the distribution of the known risk factors among the study group (number of sexual partners, age at first intercourse, and age at first pregnancy) was practically the same as those in the non-Jewish population.…”

“…Israeli Jewish women are at low risk for cancer of the uterine cervix (Sadan et al, 2003). Cervical carcinoma ranks 20th among all their cancers, with the adjusted incidence rate being B5 out of 100 000, a figure among the lowest worldwide.…”

Comparative efficacy of visual inspection with acetic acid versus cytology for cervical cancer screening in Ogbomoso, Nigeria

“…7,[22][23][24] The VIApositivity rates noted in the published studies from other regions and in some developing countries ranged from 5.7% to 28.0%. 7,9,[22][23][24][25][26][27] The wide variation in rates in the various studies may be due to different criteria and different cadres of health personnel used for screening and the different populations. 28,29 It may also depend on the study population, since few studies were done on symptomatic hospital based population, health workers and others as a mass screening test.…”

“…28,29 It may also depend on the study population, since few studies were done on symptomatic hospital based population, health workers and others as a mass screening test. 7,9,[22][23][24][25][26] The inherent variability of the appearance of the cervix may have led to different subjective interpretations of the results among different health workers.…”