Should high-risk adolescents have papanicolaou tests?

Ly T. Ma, Gerald Campbell, Gwyn Richardson, Vicki J. Schnadig

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

BACKGROUND: The current American College of Obstetricians and Gynecologists guidelines state that cervical cancer screening should begin at age 21 years, regardless of sexual or obstetric history. However, previous studies have demonstrated that there is a small but significant subset of high-risk adolescents with extensive sexual and obstetric history who harbor a significant squamous cervical lesion. The objective of the current study was to use histologic and demographic data from adolescents (aged <21 years) who received Papanicolaou (Pap) tests to determine whether they benefited from early cervical cancer screening. METHODS: Adolescent girls who had Pap tests between 2000 and 2010 were included in the study. Demographic data, including obstetric history, number of sexual partners, age of first coitus, age at first pregnancy, menarche, smoking history, and Chlamydia and syphilis infection, were analyzed for associations with levels of cervical dysplasia. RESULTS: Of 56,785 adolescent Pap tests, 277 (0.5%) were diagnosed as high-grade squamous HSIL, and 56 of those Pap tests (20%) were from patients who had grade 3 cervical intraepithelial neoplasia (CIN-3) on subsequent biopsy and/or excision. One patient had microinvasive cervical carcinoma identified on loop electrosurgical excision procedure at age 27 years after an HSIL Pap test. Increased parity was associated significantly with higher rates of CIN-3. CONCLUSIONS: The study findings indicated that current American College of Obstetricians and Gynecologists guidelines to begin Pap testing at age 21 years are appropriate for the majority of adolescents, because the rate of HSIL is very low, and the risk for invasive carcinoma is minimal. Although higher parity was associated with a significantly increased grade of CIN, the conclusions are questionable because of the significant amount of missing demographic data points. That being said, this study should lead to other similar studies to determine any association of higher grade CIN with adolescent sexual and obstetric history. Cancer (Cancer Cytopathol) 2013;121:432-9.

Original languageEnglish (US)
Pages (from-to)432-439
Number of pages8
JournalCancer cytopathology
Volume121
Issue number8
DOIs
StatePublished - Aug 2013

Fingerprint

Papanicolaou Test
History
Obstetrics
Demography
Parity
Early Detection of Cancer
Uterine Cervical Neoplasms
Guidelines
Uterine Cervical Dysplasia
Carcinoma
Chlamydia Infections
Menarche
Cervical Intraepithelial Neoplasia
Sexual Partners
Coitus
Syphilis
Neoplasms
Smoking
Biopsy
Pregnancy

Keywords

  • Adolescents
  • Cervical intraepithelial neoplasia
  • High-grade squamous intraepithelial lesion
  • Papanicolaou tests
  • Parity

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Should high-risk adolescents have papanicolaou tests? / Ma, Ly T.; Campbell, Gerald; Richardson, Gwyn; Schnadig, Vicki J.

In: Cancer cytopathology, Vol. 121, No. 8, 08.2013, p. 432-439.

Research output: Contribution to journalArticle

Ma, Ly T. ; Campbell, Gerald ; Richardson, Gwyn ; Schnadig, Vicki J. / Should high-risk adolescents have papanicolaou tests?. In: Cancer cytopathology. 2013 ; Vol. 121, No. 8. pp. 432-439.
@article{1d7df34514ee4a74ad88e97ede846161,
title = "Should high-risk adolescents have papanicolaou tests?",
abstract = "BACKGROUND: The current American College of Obstetricians and Gynecologists guidelines state that cervical cancer screening should begin at age 21 years, regardless of sexual or obstetric history. However, previous studies have demonstrated that there is a small but significant subset of high-risk adolescents with extensive sexual and obstetric history who harbor a significant squamous cervical lesion. The objective of the current study was to use histologic and demographic data from adolescents (aged <21 years) who received Papanicolaou (Pap) tests to determine whether they benefited from early cervical cancer screening. METHODS: Adolescent girls who had Pap tests between 2000 and 2010 were included in the study. Demographic data, including obstetric history, number of sexual partners, age of first coitus, age at first pregnancy, menarche, smoking history, and Chlamydia and syphilis infection, were analyzed for associations with levels of cervical dysplasia. RESULTS: Of 56,785 adolescent Pap tests, 277 (0.5{\%}) were diagnosed as high-grade squamous HSIL, and 56 of those Pap tests (20{\%}) were from patients who had grade 3 cervical intraepithelial neoplasia (CIN-3) on subsequent biopsy and/or excision. One patient had microinvasive cervical carcinoma identified on loop electrosurgical excision procedure at age 27 years after an HSIL Pap test. Increased parity was associated significantly with higher rates of CIN-3. CONCLUSIONS: The study findings indicated that current American College of Obstetricians and Gynecologists guidelines to begin Pap testing at age 21 years are appropriate for the majority of adolescents, because the rate of HSIL is very low, and the risk for invasive carcinoma is minimal. Although higher parity was associated with a significantly increased grade of CIN, the conclusions are questionable because of the significant amount of missing demographic data points. That being said, this study should lead to other similar studies to determine any association of higher grade CIN with adolescent sexual and obstetric history. Cancer (Cancer Cytopathol) 2013;121:432-9.",
keywords = "Adolescents, Cervical intraepithelial neoplasia, High-grade squamous intraepithelial lesion, Papanicolaou tests, Parity",
author = "Ma, {Ly T.} and Gerald Campbell and Gwyn Richardson and Schnadig, {Vicki J.}",
year = "2013",
month = "8",
doi = "10.1002/cncy.21274",
language = "English (US)",
volume = "121",
pages = "432--439",
journal = "Cancer cytopathology",
issn = "1934-662X",
publisher = "Wiley-Blackwell",
number = "8",

}

TY - JOUR

T1 - Should high-risk adolescents have papanicolaou tests?

AU - Ma, Ly T.

AU - Campbell, Gerald

AU - Richardson, Gwyn

AU - Schnadig, Vicki J.

PY - 2013/8

Y1 - 2013/8

N2 - BACKGROUND: The current American College of Obstetricians and Gynecologists guidelines state that cervical cancer screening should begin at age 21 years, regardless of sexual or obstetric history. However, previous studies have demonstrated that there is a small but significant subset of high-risk adolescents with extensive sexual and obstetric history who harbor a significant squamous cervical lesion. The objective of the current study was to use histologic and demographic data from adolescents (aged <21 years) who received Papanicolaou (Pap) tests to determine whether they benefited from early cervical cancer screening. METHODS: Adolescent girls who had Pap tests between 2000 and 2010 were included in the study. Demographic data, including obstetric history, number of sexual partners, age of first coitus, age at first pregnancy, menarche, smoking history, and Chlamydia and syphilis infection, were analyzed for associations with levels of cervical dysplasia. RESULTS: Of 56,785 adolescent Pap tests, 277 (0.5%) were diagnosed as high-grade squamous HSIL, and 56 of those Pap tests (20%) were from patients who had grade 3 cervical intraepithelial neoplasia (CIN-3) on subsequent biopsy and/or excision. One patient had microinvasive cervical carcinoma identified on loop electrosurgical excision procedure at age 27 years after an HSIL Pap test. Increased parity was associated significantly with higher rates of CIN-3. CONCLUSIONS: The study findings indicated that current American College of Obstetricians and Gynecologists guidelines to begin Pap testing at age 21 years are appropriate for the majority of adolescents, because the rate of HSIL is very low, and the risk for invasive carcinoma is minimal. Although higher parity was associated with a significantly increased grade of CIN, the conclusions are questionable because of the significant amount of missing demographic data points. That being said, this study should lead to other similar studies to determine any association of higher grade CIN with adolescent sexual and obstetric history. Cancer (Cancer Cytopathol) 2013;121:432-9.

AB - BACKGROUND: The current American College of Obstetricians and Gynecologists guidelines state that cervical cancer screening should begin at age 21 years, regardless of sexual or obstetric history. However, previous studies have demonstrated that there is a small but significant subset of high-risk adolescents with extensive sexual and obstetric history who harbor a significant squamous cervical lesion. The objective of the current study was to use histologic and demographic data from adolescents (aged <21 years) who received Papanicolaou (Pap) tests to determine whether they benefited from early cervical cancer screening. METHODS: Adolescent girls who had Pap tests between 2000 and 2010 were included in the study. Demographic data, including obstetric history, number of sexual partners, age of first coitus, age at first pregnancy, menarche, smoking history, and Chlamydia and syphilis infection, were analyzed for associations with levels of cervical dysplasia. RESULTS: Of 56,785 adolescent Pap tests, 277 (0.5%) were diagnosed as high-grade squamous HSIL, and 56 of those Pap tests (20%) were from patients who had grade 3 cervical intraepithelial neoplasia (CIN-3) on subsequent biopsy and/or excision. One patient had microinvasive cervical carcinoma identified on loop electrosurgical excision procedure at age 27 years after an HSIL Pap test. Increased parity was associated significantly with higher rates of CIN-3. CONCLUSIONS: The study findings indicated that current American College of Obstetricians and Gynecologists guidelines to begin Pap testing at age 21 years are appropriate for the majority of adolescents, because the rate of HSIL is very low, and the risk for invasive carcinoma is minimal. Although higher parity was associated with a significantly increased grade of CIN, the conclusions are questionable because of the significant amount of missing demographic data points. That being said, this study should lead to other similar studies to determine any association of higher grade CIN with adolescent sexual and obstetric history. Cancer (Cancer Cytopathol) 2013;121:432-9.

KW - Adolescents

KW - Cervical intraepithelial neoplasia

KW - High-grade squamous intraepithelial lesion

KW - Papanicolaou tests

KW - Parity

UR - http://www.scopus.com/inward/record.url?scp=84885042859&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84885042859&partnerID=8YFLogxK

U2 - 10.1002/cncy.21274

DO - 10.1002/cncy.21274

M3 - Article

C2 - 23450854

AN - SCOPUS:84885042859

VL - 121

SP - 432

EP - 439

JO - Cancer cytopathology

JF - Cancer cytopathology

SN - 1934-662X

IS - 8

ER -