Invasive cancer of the cervix in women with mild dyskaryosis followed up cytologically.
Mildly dyskaryotic smears are common, and women with such results are often followed up with further cervical smear tests. An important consideration in evaluating this practice would be the annual incidence of invasive cervical cancer. A reanalysis of five previous studies of the cytological follow up of women with mildly abnormal smear test results was undertaken to calculate this incidence. The annual incidence of invasive cancer in these women ranged from 0 to 420 per 100,000 women years. The large studies providing the most precise estimates had annual rates of 143 to 420 per 100,000 women years. This is 16 to 47 times greater than in women aged 15-34 years in England and Wales. The average rate was 208 per 100,000 women years. Women with mild dyskaryosis are at high risk of developing invasive cervical cancer despite cytological follow up. A full appraisal of the costs and benefits of colposcopy in this situation is urgently required.
Institute of Obstetrics and Gynaecology, Royal Postgraduate Medical School, London.
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Soutter
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Fletcher
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002584:Cervix Uteri / Q000473:pathology*; D003127:Colposcopy; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D012017:Referral and Consultation; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D014626:Vaginal Smears; D014852:Wales / Q000453:epidemiology