title: Analysis of cervico-vaginal (Papanicolaou) smears, in girls 18 years and under.
abstract: This study was conducted retrospectively at the Queen Elizabeth Hospital and a private laboratory in Barbados to determine the types of epithelial abnormalities in cervico-vaginal Papanicolaou (Pap)-stained smears, and their clinical implications in Barbadian girls, 18 years and under, during the five-year period January 1995 to December 1999. Two hundred and sixty-five Pap smears from 236 patients were examined and the gynaecological history, initial and repeat Pap smear diagnoses, and histology reports of these patients were analyzed. Of the 236 first-visit smears, 94 (39.8%) were abnormal with 36 (15.3%) displaying cytologic features of squamous intra-epithelial lesions (SIL), (33 low grade and 3 high grade). A diagnosis of atypical squamous cells of undetermined significance (ASCUS) was reported in the remaining 58 (24.5%) abnormal smears, of which 35 (60.3%) were suspected to be related to human papillomavirus (HPV) infection. Twenty-two (23.4%) of these 94 patients, who had abnormal smears of either ASCUS or low grade squamous intra-epithelial lesions (LSIL) were re-evaluated within six to twelve months of the initial abnormal Pap smear diagnosis. Eight of these 22 patients (36.4%) had histological diagnosis of LSIL inclusive of cervical intra-epithelial neoplasia grade 1 (CIN 1) and condylomata. High-risk HPV DNA types were detected in two of these eight patients (25%). The study confirms that sexually active teenage girls are at risk of developing SIL and high-risk HPV infection. Screening of sexually active teenaged girls by Pap smears followed by other appropriate investigative procedures is recommended.
authors.affiliation: School of Clinical Medicine and Research, University of the West Indies, Queen Elizabeth Hospital, Cave Hill, Barbados. prussia@cariaccess.com
authors.forename: P R
authors.initials: PR
authors.lastname: Prussia
authors.forename: G H E
authors.initials: GH
authors.lastname: Gay
authors.forename: A
authors.initials: A
authors.lastname: Bruce
mesh_terms: D000293:Adolescent; D001460:Barbados / Q000453:epidemiology; D015415:Biomarkers; D003127:Colposcopy; D005260:Female; D006801:Humans; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D015229:Sexually Transmitted Diseases, Viral / Q000175:diagnosis / Q000453:epidemiology; D014412:Tumor Virus Infections / Q000175:diagnosis / Q000453:epidemiology*; D002578:Uterine Cervical Dysplasia / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D014626:Vaginal Smears
chemical_list: D015415:Biomarkers