Abstract
Organized screening with Papanicolaou smear has reduced the prevalence of invasive cervix cancer in developed world, and in the recent screening guidelines, HPV as a co-test after 30 years of age has been added to Pap smear. The goal of screening is to find persistent HPV infection, detect and treat high-grade CIN, i.e. CIN 2 and 3 (with no margin of error), and not to miss invasive cancer. In this chapter, cytology requiring evaluation will be discussed with regard to unsatisfactory specimen and various epithelial cell abnormalities.
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References
Solomon D, Davey D, Kurman R, et al. The 2001 Bethesda system: terminology for reporting results of cervical cytology. JAMA. 2002;287(16):2114–9. doi:10.1001/jama.287.16.2114.
Guidelines – American Society for colposcopy and cervical pathology. www.asccp.org/guidelines.
Katki HA, Kinney WK, Fetterman B, Lorey T, Poitras NE, Cheung L, et al. Cervical cancer risk for women undergoing concurrent testing for human papillomavirus and cervical cytology: a population-based study in routine clinical practice. Lancet Oncol. 2011;12:663Y72.
Katki HA, Schiffman M, Castle PE, Fetterman B, Poitras NE, Lorey T, et al. Five-year risks of CIN 3+ and cervical cancer among women who test Pap-negative but are HPV-positive. J Low Genit Tract Dis. 2013;17:S56–63.
Katki HA, Schiffman M, Castle PE, Fetterman B, Poitras NE, Lorey T, et al. Five-year risk of cervical cancer and CIN3 for HPV-positive and HPV-negative high-grade Pap results. J Low Genit Tract Dis. 2013;17:S50–5.
Stoler MH, Wright TC, Sharma A, Apple R, Gutekunst K, Wright TL. High-risk human papillomavirus testing in women with ASC-US cytology: results from the ATHENA HPV study. Am J Clin Pathol. 2011;135:466–75.
Einstein MH, Martens MG, Garcia FA, Ferris DG, Mitchell AL, Day SP, et al. Clinical validation of the Cervista HPV HR and 16/18 genotyping tests for use in women with ASC-US cytology. Gynecol Oncol. 2010;118:116–22.
Guido R, Schiffman M, Solomon D, Burke L, for the ASCUS/LSIL Triage Study (ALTS) Group. Post-colposcopy management strategies for women referred with low-grade squamous intraepithelial lesions of human papillomavirus DNA-positive atypical squamous cells of undetermined significance: a two-year prospective trial. Am J Obstet Gynecol. 2003;188:1401–5.
Moore G, Fetterman B, Cox JT, Poitras N, Lorey T, Kinney W, et al. Lessons from practice: risk of CIN3 or cancer associated with an LSIL or HPV-positive ASC-US screening result in women aged 21–24. J Low Genit Tract Dis. 2010;14:97–102.
Arbyn M, Sasieni P, Meijer CJ, Clavel C, Koliopoulos G, Dillner J. Clinical applications of HPV testing: a summary of meta-analyses. Vaccine. 2006;24 Suppl 3:S78–89.
Katki HA, Gage JC, Schiffman M, Castle PE, Fetterman B, Poitras NE, et al. Follow-up testing after colposcopy: five-year risk of CIN 2+ after a colposcopic diagnosis of CIN 1 or less. J Low Genit Tract Dis. 2013;5:S69–77.
Zhao C, Florea A, Onisko A, Austin RM. Histologic follow-up results in 662 patients with Pap test findings of atypical glandular cells: results from a large academic women’s hospital laboratory employing sensitive screening methods. Gynecol Oncol. 2009;114:383–9.
Simsir A, Carter W, Elgert P, Cangiarella J. Reporting endometrial cells in women 70 years and older: assessing the clinical usefulness of Bethesda 2001. Am J Clin Pathol. 2005;123:571–5.
Hoda RS, Loukeris K, Abdul-Karim FW. Gynecologic cytology on conventional and liquid-based preparations: a comprehensive review of similarities and differences. Diagn Cytopathol. 2012;41(3):257–78. doi:10.1002/dc.22842.
Hock YL, Ramaiah S, Wall ES, Harris AM, Marston L, Marshall J, et al. Outcome of women with inadequate cervical smears followed up for five years. J Clin Pathol. 2003;56:592–5.
Ransdell JS, Davey DD, Zaleski S. Clinicopathologic correlation of the unsatisfactory Papanicolaou smear. Cancer. 1997;81:139–43.
Siebers AG, Klinkhamer PJJM, Vedder JEM, Arbyn M, Bulten J. Causes and relevance of satisfactory and satisfactory but limited smears of liquid-based compared with conventional cervical cytology. Arch Pathol Lab Med. 2012;136:76–83.
Buntinx F, Brouwers M. Relation between sampling device and detection of abnormality in cervical smears: a meta-analysis of randomized and quasi-randomised studies. BMJ. 1996;313:1285–90.
Martin-Hirsch P, Jarvis G, Kitchener H, Lilford R. Collection devices for obtaining cervical cytology samples. Cochrane Database Syst Rev 2000;CD001036.
Huang A, Quinn M, Tan J. Outcome in women with no endocervical component on cervical cytology after treatment for high-grade cervical dysplasia. Aust N Z J Obstet Gynaecol. 2009;49:426–8.
Mitchell HS. Longitudinal analysis of histologic high-grade disease after negative cervical cytology according to endocervical status. Cancer. 2001;93:237–40.
Zhao C, Austin RM. Human papillomavirus DNA detection in ThinPrep Pap test vials is independent of cytologic sampling of the transformation zone. Gynecol Oncol. 2007;107:231–5.
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Suneja, A., Pandit, U. (2017). Management Recommendations in Abnormal Cytology. In: Mehta, S., Sachdeva, P. (eds) Colposcopy of Female Genital Tract. Springer, Singapore. https://doi.org/10.1007/978-981-10-1705-6_5
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DOI: https://doi.org/10.1007/978-981-10-1705-6_5
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