Rates of condyloma and dysplasia in papanicolaou smears with and without endocervical cells

Mauney, Marc; Eide, David J.; Sotham, Joseph

doi:10.1002/dc.2840060106

Cited by 33 publications

(20 citation statements)

References 6 publications

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“…A number of studies had documented a higher abnormality rate among smears which included an endocervical component than among smears which were reported as lacking an endocervical component (Elias et al, 1983;Laverty et al, 1989;Mauney & Sotham, 1990; Vooijs et al, 1986 The rate of cytological reporting of endocervical dyskaryosis, adenocarcinoma in situ and adenocarcinoma of the cervix per 10,000 smears was calculated for the two time periods, 1987-1989 and 1990-1991 …”

mentioning

confidence: 99%

“…A number of studies had documented a higher abnormality rate among smears which included an endocervical component than among smears which were reported as lacking an endocervical component (Elias et al, 1983;Laverty et al, 1989;Mauney & Sotham, 1990;Vooijs et al, 1986). As a consequence, many laboratories devoted considerable time and resources to strategies aimed at increasing the proportion of smears with an endocervical component.…”

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confidence: 99%

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Cytological reporting of cervical abnormalities according to endocervical status

Mitchell

Medley²

1993

Br J Cancer

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Summary An analysis of cytology reporting within Victorian Cytology Service demonstrates that the proportion of Papanicolaou smears which were reported as including an endocervical component increased from approximately one half during 1987-89 to more than three quarters during . The improvement coincided with the routine provision of special sampling instruments to all practitioners supplemented by an education program. Despite the increase in endocervical sampling, no increase in the rate of reporting of high-grade intraepithelial lesions of the cervix has occurred. An increase between the two time periods in the cytological reporting of adenocarcinoma, adenocarcinoma in situ and endocervical dyskaryosis has occurred, but does not reach statistical significance.The late 1980s was a time when renewed emphasis was given to the quality of the cell sample for cervical cytology specimens. A number of studies had documented a higher abnormality rate among smears which included an endocervical component than among smears which were reported as lacking an endocervical component (Elias et al., 1983;Laverty et al., 1989;Mauney & Sotham, 1990; Vooijs et al., 1986 The rate of cytological reporting of endocervical dyskaryosis, adenocarcinoma in situ and adenocarcinoma of the cervix per 10,000 smears was calculated for the two time periods, 1987-1989 and 1990-1991 ResultsThe proportion of smears in each year from 1987 to 1991 which were reported as including an endocervical component is shown in Table I. While some fluctuation is evident, the proportion has increased from around one half to more than three quarters, with the major increase occurring between 1989 and 1990. This time period coincided with the introduc-

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confidence: 99%

“…A number of studies had documented a higher abnormality rate among smears which included an endocervical component than among smears which were reported as lacking an endocervical component (Elias et al, 1983;Laverty et al, 1989;Mauney & Sotham, 1990;Vooijs et al, 1986). As a consequence, many laboratories devoted considerable time and resources to strategies aimed at increasing the proportion of smears with an endocervical component.…”

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confidence: 99%

Cytological reporting of cervical abnormalities according to endocervical status

Mitchell

Medley²

1993

Br J Cancer

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“…It was found out that abnormal results were more common in smears containing endocervix cells than in smears without endocervix cells [21,22]. Following these studies, the assessment of endocervix cells became a standard as it was believed to increase the chance of detecting abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Is routine performance of the uterine cervix canal curettage prior to the curettage of the uterine cavity justified?

Piątek

Lipa²,

Górska³

et al. 2017

Ginekol Pol

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Objectives: Endocervical curettage (ECC) together with the dilatation and curettage of the uterine cavity (D & C) is routinely performed in everyday clinical practice. The aim of this study is to assess the rationale of the performance of ECC prior to D & C in indications other than abnormal uterine bleeding (AUB). Material and methods:Case histories of 736 patients after ECC performed in the 1 st Department of Obstetrics and Gynaecology, Medical University of Warsaw, were analyzed retrospectively, the indications for the procedure -age, menopausal status, parity, procedure operator's experience -as well as the result of the histopathology examination were taken into account. Three groups of patients were distinguished based on the indications for the procedure. Results:In 645 (87.6%) of cases normal histopathology results were obtained. 40 (5.4%) cases were abnormal. 31 cases of uterine cervix dysplasia were disclosed (CIN 1-20; CIN 2-5; CIN 3-6), 8 cases of endometrial cancer and 1 case of cancer of the uterine cervix were disclosed. In 51 (7%) of cases tissue material for histopathology examination was not obtained. In patients where ECC and D & C were performed due to indications other than abnormal bleeding from uterine cavity, no abnormal results were revealed. In addition, in this group the highest number of non-diagnostic ECCs was reported (11.59%; p < 0.05). Conclusions:In the case of endometrial biopsy for indications other than AUB routine ECC prior to D & C need not be performed.

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“…1 Although a conclusive definition of "adequate sample" remains elusive, the retrieval of endocervical cells from an area of the cervix known as the transformation zone or squamocolumnar junction, from which most abnormalities arise, 4 has historically been considered an indication of quality. 5 Some older studies [5][6][7][8][9][10][11][12][13][14] have shown a relationship between the presence of endocervical cells and the identification of cervical abnormality. Such findings are consistent with the hypothesis that samples with endocervical cells are more likely to detect atypia.…”

Section: What Is An Adequate Sample?mentioning

confidence: 99%

“…[5][6][7][8][9][10]12,13 One study 8 assessing the cytologic histories of 376 women diagnosed with invasive carcinoma of the cervix found that endocervical cells were seen less often in smears reported as negative (45.5%) than in those with atypia (84.4%) and those with cervical intraepithelial neoplasia (97.8%). This difference was significant (p < 0.001), suggesting that the composition of the smear was related to the detection of abnormalities.…”

Section: What Is the Evidence?mentioning

confidence: 99%

Management of Papanicolaou test results that lack endocervical cells

Elumir-Tanner

Doraty²

2011

Canadian Medical Association Journal

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Mrs. McTavish is a 25-year old patient whose Papanicolaou (Pap) test results have come back from the laboratory. The smear is described as satisfactory for evaluation; however, it is noted that an inadequate number of endocervical cells were present in the sample. The results of the patient's past Pap tests have been satisfactory for evaluation and negative for abnormality. She is otherwise well. Her physical examination, including pelvic examination, showed nothing unusual. R ates of cervical cancer have been declining in Canada since the implementation of the Papanicolaou (Pap) smear, with reduction in both incidence (from 11.1 per 100 000 in 1970-1972 to 5.2 per 100 000 in [1994][1995][1996] and mortality (7.9 per 100 000 in 1953-1955 to 1.9 per 100 000 in [1995][1996][1997].1 Further improvements will depend on the continuance of screening for cervical cancer and the effectiveness of screening tools. The Bethesda System -the conventional system for reporting cervical cytologic diagnoses -provides feedback about specimen adequacy using the categories "satisfactory" or "unsatisfactory."2 Primary health care providers may receive Pap test results that are identified as satisfactory but accompanied by a note that indicates a sample from the transformation zone is lacking. Some provincial and national guidelines are unclear about how clinicians should respond to this type of report. Because of this uncertainty, we sought to review the current evidence on the topic. How should a care provider proceed with screening when faced with an otherwise satisfactory Pap smear that lacks sampling from the transformation zone? If physicians continue with regular screening intervals without special attention to the lack of endocervical cells, are cervical abnormalities being missed? Literature reviewWe searched MEDLINE from 1975 to the end of July 2010 using the following combination of keywords and subject headings: "unsatisfactory Pap smear," "endocervical component," "endocervical status," "endocervical cells and Pap smear," "Pap smear and quality" and "abnormal Pap smear." Bibliographies from the identified articles were manually searched. Summary sites such as Towards Optimal Practice (Alberta) and Cancer Care Manitoba were also reviewed in July 2010. We identified 462 citations, and reviewed 53 full-text articles. Papers were excluded if they were written in a language other than English, if they did not discuss the topic of Pap smear quality and presence or absence of endocervical cells, and if there were insufficient data to draw conclusions. Twenty-four articles were included in our review and are summarized in Appendix 1 (available at www .cmaj .ca/cgi /content /full /cmaj .101156 /DC1).The level of evidence was determined by the hierarchy developed by the Canadian Task Force on the Periodic Health Examination, 3 according to which the highest level of evidence (Level I) derives from at least one randomized controlled trial, and the lowest level derives from the opinion of experts (Level III). The evidence identified...

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Rates of condyloma and dysplasia in papanicolaou smears with and without endocervical cells

Cited by 33 publications

References 6 publications

Cytological reporting of cervical abnormalities according to endocervical status

Cytological reporting of cervical abnormalities according to endocervical status

Is routine performance of the uterine cervix canal curettage prior to the curettage of the uterine cavity justified?

Management of Papanicolaou test results that lack endocervical cells

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