TY - JOUR
T1 - Preinvasive and Invasive Cervical Adenocarcinoma
T2 - Preceding Low-Risk or Negative Pap Result Increases Time to Diagnosis
AU - Moukarzel, Lea A.
AU - Angarita, Ana M.
AU - Vandenbussche, Christopher
AU - Rositch, Anne
AU - Thompson, Carol B.
AU - Fader, Amanda N.
AU - Levinson, Kimberly
N1 - Publisher Copyright:
© 2016, American Society for Colposcopy and Cervical Pathology.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Objectives The aims of the study were to investigate screening histories of women with adenocarcinoma in situ (AIS) and adenocarcinoma (AdCa) of the cervix and to further evaluate screening for glandular disease. Materials and Methods Screening histories were retrospectively collected for patients with AIS or AdCa at a single large-volume academic institution from 2005 to 2015. Fisher exact and Wilcoxon rank sum tests were used to compare AIS with AdCa patient characteristics, distribution of preceding Pap (i.e., trigger Pap) results, and high-risk human papillomavirus testing. The association between Pap result and time to diagnosis was evaluated. Results Eighty-seven cases, 50 AIS and 37 AdCa, met study criteria; median age was 31 and 43 years, respectively. Among the AIS cohort, 52.0% had a negative or low-risk trigger Pap result versus 24.3% of those with AdCa (p =.001). The time to diagnosis of AIS ranged from 8.4 to 18.8 weeks for those with high- versus low-risk or negative trigger Pap results, respectively (p =.002). The time to diagnosis of AdCa ranged from 14.6 to 44.7 weeks for those with high- versus low-risk or negative trigger Pap results, respectively (p =.003). Among those with high-risk human papillomavirus testing, 89.7% tested positive at the time of trigger Pap with 100% positivity among those with low-risk or negative trigger Pap results. Conclusions Cervical AIS and AdCa affect many young nulliparous women and commonly preceded by low-risk or negative Pap testing. The interval to diagnosis increases with low-risk and negative Pap results, and therefore, further investigation into optimal screening for glandular lesions is needed.
AB - Objectives The aims of the study were to investigate screening histories of women with adenocarcinoma in situ (AIS) and adenocarcinoma (AdCa) of the cervix and to further evaluate screening for glandular disease. Materials and Methods Screening histories were retrospectively collected for patients with AIS or AdCa at a single large-volume academic institution from 2005 to 2015. Fisher exact and Wilcoxon rank sum tests were used to compare AIS with AdCa patient characteristics, distribution of preceding Pap (i.e., trigger Pap) results, and high-risk human papillomavirus testing. The association between Pap result and time to diagnosis was evaluated. Results Eighty-seven cases, 50 AIS and 37 AdCa, met study criteria; median age was 31 and 43 years, respectively. Among the AIS cohort, 52.0% had a negative or low-risk trigger Pap result versus 24.3% of those with AdCa (p =.001). The time to diagnosis of AIS ranged from 8.4 to 18.8 weeks for those with high- versus low-risk or negative trigger Pap results, respectively (p =.002). The time to diagnosis of AdCa ranged from 14.6 to 44.7 weeks for those with high- versus low-risk or negative trigger Pap results, respectively (p =.003). Among those with high-risk human papillomavirus testing, 89.7% tested positive at the time of trigger Pap with 100% positivity among those with low-risk or negative trigger Pap results. Conclusions Cervical AIS and AdCa affect many young nulliparous women and commonly preceded by low-risk or negative Pap testing. The interval to diagnosis increases with low-risk and negative Pap results, and therefore, further investigation into optimal screening for glandular lesions is needed.
KW - cervical adenocarcinoma
KW - cervical adenocarcinoma in situ
KW - cervical cancer screening
KW - human papillomavirus
KW - human papillomavirus
KW - pap smear
KW - pap test
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U2 - 10.1097/LGT.0000000000000286
DO - 10.1097/LGT.0000000000000286
M3 - Article
C2 - 27977543
AN - SCOPUS:85006241101
SN - 1089-2591
VL - 21
SP - 91
EP - 96
JO - Journal of lower genital tract disease
JF - Journal of lower genital tract disease
IS - 2
ER -