title: Rapidly progressive cervical cancer: the Connecticut experience.
abstract: A review is presented of 15 years of clinical experience working with women who developed cervical cancer within a short interval after the last reported negative Papanicolaou smear. Our initial report concerned isolated cases in which women were diagnosed with invasive cervical cancer within 1 year of a reported normal Papanicolaou smear. Our second report focused on a 10-year review of the Yale-New Haven Hospital experience, during which 40 of 555 women had rapidly progressive invasive disease; 35 cases (87.5%) occurred in women younger than 40 years old and almost all of the 40 diagnosed because of persistent symptoms despite a recent normal Papanicolaou smear. Our final experience is a population-based study of all women in Connecticut who developed cervical cancer between 1985 and 1990. A total of 118 of 481 (24.5%) participants were diagnosed with cervical cancer within 3 years of their last true-negative Papanicolaou smear. Adenocarcinomas occurred in 38 cases (32.2%). These data suggest that rapidly occurring cervical cancer may be a manifestation of endocervical carcinomas that have been inadequately screened.
authors.affiliation: Department of Obstetrics and Gynecology, University of Connecticut School of Medicine, New Haven, USA.
authors.forename: P E
authors.initials: PE
authors.lastname: Schwartz
authors.forename: O
authors.initials: O
authors.lastname: Hadjimichael
authors.forename: D M
authors.initials: DM
authors.lastname: Lowell
authors.forename: M J
authors.initials: MJ
authors.lastname: Merino
authors.forename: D
authors.initials: D
authors.lastname: Janerich
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000328:Adult; D018196:Carcinoma, Adenosquamous / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D065006:Papanicolaou Test; D011446:Prospective Studies; D012189:Retrospective Studies; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D014626:Vaginal Smears