[Long-term follow-up of women with first-time diagnosis of mild dysplasia detected by cytological examination of the cervix].
BACKGROUND
Since 1990, women in Northern Jutland having the cytologic first-time diagnosis of mild dysplasia have been managed according to age-differentiated guidelines. It was the purpose of this study to evaluate these guidelines focusing on compliance, progression, treatment, and follow-up after treatment.


METHODS
Register-based follow-up study comprising 993 women with the cytologic first-time diagnosis of mild dysplasia entered into the database file of the Department of Pathology of Aalborg Hospital in the period 1990-1991.


RESULTS
The first follow-up examination after the initial cytology was performed four months (median) later. The age was negatively associated to the time for the follow-up (p < 0.0001). 18% of the women were later presenting with a diagnosis of at least moderate dysplasia, among whom four cases of invasive cancer stage 1A1 were observed. Age was not significantly associated to the risk of progression (p = 0.32). In contrast, earlier atypical smear was strongly positively related to later progression (p = 0.003). 39% of the women were treated during the observation period. After treatment the first follow-up examination was performed after 20 (median) months. Younger women were examined later than older women (p < 0.0001). 6.1% of the women treated were later diagnosed as having cervix neoplasia.


CONCLUSIONS
1) Compliance was not optimal. 2) Cytologic follow-up after six months is a safe method in the management of mild dysplasia. 3) Age-differentiated follow-up procedure is not justified. 4) Earlier atypical smear was an important risk factor for progression. 5) The follow-up after treatment should be standardized and EDP monitoring implemented.
Knudsen
Aage
A
Aalborg Sygehus Nord, Gynaekologisk-obstetrisk Afdeling og Patologisk Institut. aageknudsen@dadlnet.dk
Nielsen
Karsten
K
Sandahl
Preben
P
Andersen
Erik Søgaard
ES
D000367:Age Factors; D000368:Aged; D003718:Denmark; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012042:Registries; D012307:Risk Factors; D002578:Uterine Cervical Dysplasia / Q000473:pathology*; D014626:Vaginal Smears