Significance of benign endometrial cells in papanicolaou tests from women aged ≥ 40 years

Thrall, Michael J.; Kjeldahl, Klint; Savik, Kay; Gulbahce, H. Evin; Pambuccian, Stefan E.

doi:10.1002/cncr.21156

Cited by 35 publications

(29 citation statements)

References 42 publications

(27 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[8][9][10][11] The specificity of the ThinPrep test for identifying atypical endometrial cells and the cytomorphologic appearance of endometrial cancer in ThinPrep smears are yet to be determined. The recommendation in the Bethesda System 12 that benign endometrial cells are to be reported in any woman older than 40 years has not improved the detection rate of endometrial cancer, 13,14 raising questions about the reliability of the criteria for distinguishing benign from atypical or frankly malignant endometrial cells.…”

mentioning

confidence: 99%

Diagnostic Value of the Thin-Layer, Liquid-Based Pap Test in Endometrial Cancer

Tomashefski¹,

Khiyami²

2007

Acta Cytologica

View full text Add to dashboard Cite

mentioning

confidence: 99%

Diagnostic Value of the Thin-Layer, Liquid-Based Pap Test in Endometrial Cancer

Tomashefski¹,

Khiyami²

2007

Acta Cytologica

View full text Add to dashboard Cite

“…Some studies have shown that the presence of nEMCs in premenopausal women is not significantly correlated with any endometrial pathology and therefore does not need to be reported [6,7]. Furthermore, another study on women aged ≥40 years failed to show any significant correlation of endometrial hyperplasia or malignancy that had been diagnosed histopathologically with the presence of benign endometrial cells on previous Pap cytology [14]. A review by Fadare et al [5] concluded that in 72% of cases, there was no significant pathology upon histological evaluation of the endometrial cells on cervicovaginal smears; in 24%, the follow-up samplings were diagnostic, with the findings classified as significant (11%) and benign (13%) pathology, and the rest being nondiagnostic.…”

Section: Discussionmentioning

confidence: 99%

“…In the study by Thrall et al [14], 3% of women aged ≥40 years had nEMCs in their Pap test. In our study, the mean age of these women was 48.7 years, similar to that reported by Bean et al [9] (46.6 years) and Thrall et al [14] (46.8 years).…”

Section: Discussionmentioning

confidence: 99%

“…Two of these 3 cases presented with abnormal vaginal bleeding. The study by Thrall et al [14] included a control group of women with no endometrial cells in their Pap tests. Their study also showed that the rate of discovery of endometrial hyperplasia and malignancy is not higher among the women who had nEMCs.…”

Section: Discussionmentioning

confidence: 99%

“…Atypical endometrial cells must still be reported under the general category of epithelial cell abnormality. Although TBS 2001 recommends reporting nEMCs in women 40 years or older, several studies have revealed that the incidence of reporting nEMCs has increased and follow-up endometrial sampling is being performed more than before, but that the rate of discovery of significant endometrial pathology has not increased [9,6,14,15,16]. Considering the high incidence of endometrial cancer, the poor sensitivity of available modalities in early diagnosis and the absence of cost-effective management methods, it is important to recognize the frequency of significant endometrial lesions in women who have nEMCs on cytology and the associated risk factors (e.g.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Normal-Appearing Endometrial Cells in Pap Tests of Women Aged Forty Years or Older and Cytohistological Correlates

Izadi-Mood

Sarmadi²,

Sanii³

et al. 2015

Acta Cytologica

View full text Add to dashboard Cite

Objective: The Bethesda System 2001 for reporting cervical cytology recommends reporting benign-appearing, exfoliated endometrial cells in women aged 40 years or older. The objective of this study was to determine the significance of normal endometrial cells in conventional Papanicolaou (Pap) tests of women aged 40 years and older and to correlate this finding with histological follow-up. Study Design: Over a period of 5 years, all Pap tests showing endometrial cells in women aged ≥40 years were identified. Histological follow-up and outcome were evaluated. Results: Out of 17,275 Pap tests, 199 (1.15%) showed benign endometrial cells. Forty-seven of these 199 patients had subsequent tissue sampling by surgical procedures including endometrial curettage (n = 31), lower genital tract biopsy (n = 30) and hysterectomy (n = 2). Overall, out of 47 cases, 3 (6.4%) had significant endometrial pathology including 2 simple hyperplasias without atypia and 1 complex hyperplasia with atypia. Conclusion: The incidence of clinically significant endometrial lesions associated with the presence of endometrial cells in Pap tests of women aged 40 years and older was very low. Considering this finding, women aged between 40 and 50 years with benign endometrial cells in a Pap test should undertake endometrial sampling only when additional clinical indicators are recognized.

show abstract

Routine endometrial sampling of asymptomatic premenopausal women shedding normal endometrial cells in papanicolaou tests is not cost effective

Kapali

Agaram

Dabbs

et al. 2007

Cancer

View full text Add to dashboard Cite

BACKGROUND. Following The Bethesda System 2001 (TBS 2001) recommendation to report normal endometrial cells (nEMC) in women ages ≥40 years, studies have shown that endometrial (EM) sampling has increased, but detection of significant EM pathology has not increased. The cost implications of this increased EM sampling have not been specifically addressed. The aim of this study was to assess the cost effectiveness of EM sampling in women ages ≥40 years with nEMC in their Papanicolaou tests. METHODS. The authors reviewed 499 cases at a large academic women's hospital where nEMC had been reported in Papanicolaou tests followed by EM tissue sampling. Relevant clinical information was obtained from cytopathology and surgical pathology reports. Data on costs of EM sampling were obtained from business offices. RESULTS. Of 1049 women ages ≥40 years who were shedding nEMC, 499 (48%) had follow‐up EM sampling. In follow‐up EM sampling, 6 cases of significant pathology (atypical complex EM hyperplasia or adenocarcinoma) were detected. Asymptomatic women totaled 350, and the total cost for EM sampling of asymptomatic patients shedding nEMC was estimated at $107,272. Three of the asymptomatic patients had significant EM pathology, but all 3 were postmenopausal. Three additional premenopausal patients with significant pathology were symptomatic with vaginal bleeding. CONCLUSIONS. No asymptomatic premenopausal patients shedding nEMC either before or after Day 12 of their menstrual cycle were found to have significant EM pathology in this large study of almost 500 women with nEMC in their Papanicolaou tests. The total costs, when projected nationally, for EM sampling in asymptomatic premenopausal women were highly significant. Educational discussions with clinicians in this community are underway to reduce the number of women who undergo EM sampling after Papanicolaou test findings of nEMC. Routine EM sampling of asymptomatic premenopausal women with nEMC in Papanicolaou tests is not cost‐effective. Cancer (Cancer Cytopathol) 2007. © 2007 American Cancer Society.

show abstract

Significance of benign endometrial cells in papanicolaou tests from women aged ≥ 40 years

Cited by 35 publications

References 42 publications

Diagnostic Value of the Thin-Layer, Liquid-Based Pap Test in Endometrial Cancer

Diagnostic Value of the Thin-Layer, Liquid-Based Pap Test in Endometrial Cancer

Normal-Appearing Endometrial Cells in Pap Tests of Women Aged Forty Years or Older and Cytohistological Correlates

Routine endometrial sampling of asymptomatic premenopausal women shedding normal endometrial cells in papanicolaou tests is not cost effective

Contact Info

Product

Resources

About