Clinical predictors of cervical intraepithelial neoplasia 2 or greater in women with mildly abnormal Pap smears.
OBJECTIVE
To evaluate clinical predictors of cervical intraepithelial neoplasia (CIN) 2 or greater in women with mildly abnormal Pap smears.


METHODS
Using a computerized colposcopy database of 2,200 women, we identified 1,494 with atypical squamous cells of undetermined significance (ASCUS) or low grade squamous intraepithelial lesions (LSILs). Of the 1,494, 1,016 (68%) underwent biopsy and formed the cohort for this retrospective review. Clinical variables associated with CIN 2 or greater in a univariate analysis (P < .10) were included in a multivariate regression analysis.


RESULTS
Of the 1,016 women biopsied, 195 (19%) had CIN 2 or greater. In the initial analysis, age (< 35 years), race (Caucasian and African American), marital status (unmarried) and smoking status (current and former) were found to be significantly associated with more severe histologic disease. In the regression analysis, a history of smoking remained a statistically significant clinical predictor of CIN 2 or greater (odds ratio 1.57, 95% confidence intervals 1.09-2.27).


CONCLUSIONS
A significant predictor of CIN 2 or greater in a large cohort of women with mildly abnormal Pap smears was a history of current or former smoking.
Boardman
Lori A
LA
Department of Obstetrics and Gynecology, Women and Infants' Hospital of Rhode Island, Brown Medical School, Providence, Rhode Island, USA. lboardma@wihri.org
Adams
Ann E
AE
Peipert
Jeffrey F
JF
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000145:classification / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D015331:Cohort Studies; D003127:Colposcopy; D005260:Female; D006801:Humans; D065006:Papanicolaou Test; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012237:Rhode Island / Q000453:epidemiology; D012307:Risk Factors; D012907:Smoking; D002583:Uterine Cervical Neoplasms / Q000145:classification / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000145:classification / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology