TY - JOUR
T1 - Cervical Papanicolaou smear abnormalities in Inner City Bronx adolescents
T2 - Prevalence, progression, and immune modifiers
AU - Edelman, Morris
AU - Fox, Amy S.
AU - Alderman, Elizabeth M.
AU - Neal, Wendy
AU - Shapiro, Alan
AU - Silver, Ellen J.
AU - Spigland, Ilya
AU - Suhrland, Mark
PY - 1999/8/25
Y1 - 1999/8/25
N2 - BACKGROUND. The aim of this study was to quantify the prevalence of cervical smear abnormalities in sexually active adolescents and identify the effect of immune-modifying conditions. METHODS. Two hundred seventy-one females ages 13-22 years attending a clinic for sexually transmitted disease (STD) evaluation had cervical Papanicoloau (Pap) smears and completed sexual history questionnaires. Results of all follow-up Pap smears were obtained. Medical charts were available for 54 patients with cytologic follow-up and were reviewed for the presence of immune-modifying conditions. Follow-up smear results for patients with and without immune-modifying conditions were compared. Abnormality rates for all cervical smears seen in 1995 at Montefiore Medical Center were also obtained. RESULTS. The smear abnormality rate for adolescents was 20.7% (abnormal squamous cells of undetermined significance [ASCUS], 12.2%; low grade squamous intraepithelial lesion [LGSIL], 7.7%; high grade squamous intraepithelial lesion [HGSIL], 0.7%) compared with all adult females, for whom the rate was 13.2% (ASCUS, 9.9%; LGSIL, 2.5%; HGSIL, 0.6%; carcinoma 0.2%) (P < 0.0002). Of 20 initial ASCUS patients, 6 (30%) showed LGSIL or HGSIL on follow-up. Chart review allowed the clinical immune status of 54 patients to be determined. Of 14 patients with an immune-modifying condition (9 HIV positive patients, 3 receiving oral steroids, 1 liver transplant patient receiving steroids, and 1 with intestinal lymphangiectasia), 11 (78.6%) developed or maintained an abnormality on cytologic follow-up. Of 40 patients with no identifiable immune-modifying condition, 11 (27.5%) developed or maintained an abnormality on cytologic follow-up (P < 0.00082). CONCLUSIONS. Sexually active adolescents are at higher risk of developing a significant cervical smear abnormality, especially LGSIL. Patients with an atypical Pap smear or immune- modifying condition require more attentive gynecologic monitoring.
AB - BACKGROUND. The aim of this study was to quantify the prevalence of cervical smear abnormalities in sexually active adolescents and identify the effect of immune-modifying conditions. METHODS. Two hundred seventy-one females ages 13-22 years attending a clinic for sexually transmitted disease (STD) evaluation had cervical Papanicoloau (Pap) smears and completed sexual history questionnaires. Results of all follow-up Pap smears were obtained. Medical charts were available for 54 patients with cytologic follow-up and were reviewed for the presence of immune-modifying conditions. Follow-up smear results for patients with and without immune-modifying conditions were compared. Abnormality rates for all cervical smears seen in 1995 at Montefiore Medical Center were also obtained. RESULTS. The smear abnormality rate for adolescents was 20.7% (abnormal squamous cells of undetermined significance [ASCUS], 12.2%; low grade squamous intraepithelial lesion [LGSIL], 7.7%; high grade squamous intraepithelial lesion [HGSIL], 0.7%) compared with all adult females, for whom the rate was 13.2% (ASCUS, 9.9%; LGSIL, 2.5%; HGSIL, 0.6%; carcinoma 0.2%) (P < 0.0002). Of 20 initial ASCUS patients, 6 (30%) showed LGSIL or HGSIL on follow-up. Chart review allowed the clinical immune status of 54 patients to be determined. Of 14 patients with an immune-modifying condition (9 HIV positive patients, 3 receiving oral steroids, 1 liver transplant patient receiving steroids, and 1 with intestinal lymphangiectasia), 11 (78.6%) developed or maintained an abnormality on cytologic follow-up. Of 40 patients with no identifiable immune-modifying condition, 11 (27.5%) developed or maintained an abnormality on cytologic follow-up (P < 0.00082). CONCLUSIONS. Sexually active adolescents are at higher risk of developing a significant cervical smear abnormality, especially LGSIL. Patients with an atypical Pap smear or immune- modifying condition require more attentive gynecologic monitoring.
KW - Adolescent
KW - Cervical intraepithelial neoplasia
KW - Cytology
KW - Immune deficiency
KW - Papanicoloau smear
UR - http://www.scopus.com/inward/record.url?scp=0033603778&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033603778&partnerID=8YFLogxK
U2 - 10.1002/(sici)1097-0142(19990825)87:4<184::aid-cncr4>3.0.co;2-%23
DO - 10.1002/(sici)1097-0142(19990825)87:4<184::aid-cncr4>3.0.co;2-%23
M3 - Article
C2 - 10455205
AN - SCOPUS:0033603778
SN - 0008-543X
VL - 87
SP - 184
EP - 189
JO - Cancer
JF - Cancer
IS - 4
ER -