A descriptive analysis of prevalent vs incident cervical intraepithelial neoplasia grade 3 following minor cytologic abnormalities

Philip E. Castle, Patti E. Gravitt, Nicolas Wentzensen, Mark Schiffman

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Cervical intraepithelial neoplasia grade 3 (CIN 3) is the best proxy in research and screening for invasive cancer risk. Yet the timing of CIN 3 development is uncertain because of measurement errors integral to its diagnosis. We were interested in estimating the proportions of prevalent vs incident CIN 3 within 2 years of finding a minor cytologic abnormality. We estimate that only 17 (2.8%) of 613 CIN 3 cases diagnosed during the 2-year duration of the atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LSIL) triage study (ALTS) were incident CIN 3 following an incident human papillomavirus (HPV) infection that persisted until the CIN 3 diagnosis was made. Using prevalent high-grade cytology as a marker of prevalent CIN 3, we estimated that another approximately 23% of CIN 3 cases were incident CIN 3 following a prevalently detected HPV infection that persisted until the CIN 3 diagnosis was made. We concluded that most CIN 3 cases diagnosed within the 2-year time frame were prevalent cases, and most incident CIN 3 cases followed a prevalently detected HPV infection. Copyright

Original languageEnglish (US)
Pages (from-to)241-246
Number of pages6
JournalAmerican journal of clinical pathology
Volume138
Issue number2
DOIs
StatePublished - Aug 2012

Keywords

  • Cervical intraepithelial neoplasia (CIN)
  • Cytology
  • Human papillomavirus (HPV)
  • Pap

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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