Accuracy and survival benefit of cytological prediction of endometrial carcinoma on routine cervical smears.
Among 359 women who received a cytology report of endometrial malignancy from the Victorian Cytology Service during 1982-87, the positive predictive value for a later histological diagnosis of endometrial malignancy was 64%. The positive predictive value was significantly higher for the group of women in whom the cytopathologists made definite predictions of endometrial malignancy as compared to the group where the cytologic features were only suggestive of endometrial malignancy (75% vs. 50%, chi 2 = 23.4; p < 0.001). The sensitivity of cervical cytology performed within two years of the diagnosis of endometrial malignancy was 28%. The odds ratio of death from endometrial cancer among women where the cytology may have allowed for an early diagnosis in comparison to women where cytology did not hasten the diagnosis was 0.78 (95% confidence interval = 0.25-2.47; p > 0.05). We conclude that while cervical cytology can predict the presence of malignancy for a small proportion of women with endometrial cancer, there remains no evidence that a cervical cancer screening program will make a major impact on reducing the morbidity and mortality from endometrial cancer.
Mitchell
H
H
Victorian Cytology Service, Carlton South, Australia.
Giles
G
G
Medley
G
G
D016889:Endometrial Neoplasms / Q000401:mortality* / Q000473:pathology*; D005260:Female; D006801:Humans; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D015996:Survival Rate; D014626:Vaginal Smears