Document Detail


Comparative risk of high-grade histopathology diagnosis after a CIN 1 finding in endocervical curettage versus cervical biopsy.
MedLine Citation:
PMID:  23343702     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: No evidence-based clinical management recommendations exist for women with an endocervical curettage (ECC) cervical intraepithelial neoplasia grade 1 (CIN 1) result when the concurrent cervical biopsy is not high-grade. For women with these pathologic findings, we assessed their short-term risk of high-grade histopathologic diagnosis in the Calgary Health Region where ECC was routinely performed.
MATERIALS AND METHODS: We analyzed pathology and colposcopy reports from 1,902 referral colposcopies where both ECC and biopsies were normal or CIN 1. We calculated the short-term risk of CIN 2 or more severe (CIN 2+) detected 12 to 24 months after colposcopy. Pearson χ tests or Fisher exact tests were used to compare risks of a CIN 2+ diagnosis between combinations of test results and strata of risk factors.
RESULTS: The short-term risk of CIN 2+ was the same after a CIN 1 biopsy and CIN 1 ECC (4.9% of 1,389 vs 5.0% of 359, respectively, p = .37). Compared with low-grade referral cytology, the risk of CIN 2+ after high-grade cytology was elevated significantly for CIN 1 ECC (13.3% vs 3.3%, p < .01) and nonsignificantly for CIN 1 biopsy (7.1% vs 4.6%, p = .12).
CONCLUSIONS: After low-grade cytology, the short-term risk of a high-grade histologic diagnosis in women with either CIN 1 ECC or biopsy is equivalent, suggesting similar management. A CIN 1 ECC may warrant different management in the context of high-grade referral cytology.
Authors:
Julia C Gage; Máire A Duggan; Jill G Nation; Song Gao; Philip E Castle
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, N.I.H., Intramural    
Journal Detail:
Title:  Journal of lower genital tract disease     Volume:  17     ISSN:  1526-0976     ISO Abbreviation:  J Low Genit Tract Dis     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-25     Completed Date:  2013-09-02     Revised Date:  2014-04-02    
Medline Journal Info:
Nlm Unique ID:  9704963     Medline TA:  J Low Genit Tract Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  137-41     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Biopsy / methods*
Cervical Intraepithelial Neoplasia / diagnosis*
Curettage / methods*
Female
Histocytochemistry / methods*
Humans
Middle Aged
Specimen Handling / methods*
Uterine Cervical Neoplasms / diagnosis*
Young Adult
Grant Support
ID/Acronym/Agency:
Z99 CA999999/CA/NCI NIH HHS
Comments/Corrections

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