The incidence of cervical intraepithelial neoplasia among women with renal transplant in relation to cyclosporine.
OBJECTIVE
To evaluate the policy of an annual smear to screen renal transplant recipients for cervical intraepithelial neoplasia and invasive carcinoma and to determine the incidence of abnormal smears and CIN before and after the introduction of cyclosporine (1983).


METHODS
A retrospective study over the period 1971 to 1992.


METHODS
Postmenarchial women who received renal transplants and who were on immunosuppressive treatment for at least one month.


METHODS
Cytology and histology results.


RESULTS
A total of 144 women who received renal transplantation were eligible for our study. Observation time varied from 1 to 227 months (median 59 months) with a mean for the group transplanted before 1983 (Group A) of 103 months, and for the group transplanted after 1983 (Group B) of 46 months. Of these women, 25 had an abnormal smear. Of these, 14 were confirmed by histology and repeated smears of the other 11 patients were negative. Within the 60 women in Group A with an abnormal smear, six had CIN I or CIN II, three had CIN III and one showed adenocarcinoma of the endometrium. Among the 84 women in Group B, four had CIN I or CIN II and none had CIN III. The overall incidence of abnormal cytology was 17.3%, with no invasive cervical carcinoma in this group.


CONCLUSIONS
Our policy of screening is adequate. With the introduction of cyclosporine the incidence of abnormal cytology and histology has a tendency to decrease. However, the duration of risk is not comparable yet.
Department of Obstetrics and Gynaecology, Academic Hospital Rotterdam Dijkzigt, The Netherlands.
S A
SA
ter Haar-van Eck
J
J
Rischen-Vos
S
S
Chadha-Ajwani
F J
FJ
Huikeshoven
D000293:Adolescent; D000328:Adult; D000368:Aged; D002584:Cervix Uteri / Q000473:pathology; D016572:Cyclosporine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation; D008403:Mass Screening; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000473:pathology
D016572:Cyclosporine