title: Prevalence of squamous abnormalities in women with a recent smear without endocervical cells is lower as compared to women with smears with endocervical cells.
abstract: The purpose of this study was to determine the prevalence rate ratio of squamous lesions in women with recent smears without endocervical component (ECC-) versus women having a smear with ECC+ and to estimate the true prevalence of these lesions in women with ECC- smears by addition of short-term follow-up results of negative ECC- smears. Results of initial smears in a 3-year period, as well as follow-up results of negative ECC- smears in the same period were retrieved. Women were categorized into two groups: having ECC- and ECC+ smears. The data were analysed for three outcome parameters, ASCUS or higher (ASCUS+), LSIL or higher (LSIL+) and HSIL or higher (HSIL+). Squamous abnormalities occurred far less frequently in women with initial ECC- than with ECC+ smears. Prevalence rate ratio (PRR) was 0.27 for ASCUS+, 0.39 for LSIL+ and 0.36 for HSIL+. Addition of follow-up results of negative ECC- smears, as a correction for false-negative ECC- smears, results in PRRs which are still significantly lower than 1, and most marked in subset HSIL+ (PRR = 0.60). We conclude that the true prevalence of squamous lesions in women with recent ECC- smears is significantly lower as compared with ECC+ smears. These findings lent support to the decision to abolish the repeat of ECC- smears in the Dutch population screening programme.
authors.affiliation: Department of Pathology, University Medical Center, CM Nijmegen, The Netherlands. b.siebers@pathol.azn.nl
authors.forename: A G
authors.initials: AG
authors.lastname: Siebers
authors.forename: H
authors.initials: H
authors.lastname: de Leeuw
authors.forename: A L M
authors.initials: AL
authors.lastname: Verbeek
authors.forename: A G J M
authors.initials: AG
authors.lastname: Hanselaar
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000473:pathology*; D004847:Epithelial Cells / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D015203:Reproducibility of Results; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*; D014626:Vaginal Smears / Q000379:methods