Cervical cytology screening history of women diagnosed with adenocarcinoma in situ of the cervix: a case-control study.
OBJECTIVE
To determine whether women diagnosed with adenocarcinoma in situ (AIS) of the cervix are as well screened as healthy control women.


METHODS
A case-control study was performed (307 cases, 1,228 controls) within a statewide registry. Cases consisted of women diagnosed with AIS on histology between 1995 and 2001. Screening histories were compiled from registry records. Variables of interest included number of previous negative Pap smears, time interval since last negative Pap smear, median time between previous negative Pap smears, proportion of negative Pap smears with an endocervical component and history of cervical abnormality.


RESULTS
Conditional logistic regression showed that cases and controls did not differ significantly in the number of previous negative smears or in the median time between previous negative smears. Decreasing time since last negative smear was protective against AIS, with controls more likely to have had a recent negative smear. There was no difference in the proportion of previous negative smears with an endocervical component between cases and controls; however, some complex temporal relationships were observed in the regression analysis.


CONCLUSIONS
Women who are diagnosed with AIS have a screening history similar to that of healthy, control women. The findings are consistent with the concept that AIS is predominantly a screening-detected disease.
Victorian Cervical Cytology Registry, Macfarlane Burnet Institute for Medical Research and Public Health, and Victorian Cytology Service, Melbourne, Australia. heather.mitchell@vccr.org
Heather
H
Mitchell
Jane
J
Hocking
Marion
M
Saville
D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology* / Q000517:prevention & control; D000328:Adult; D000367:Age Factors; D002278:Carcinoma in Situ / Q000453:epidemiology / Q000473:pathology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000592:standards / Q000706:statistics & numerical data*; D008487:Medical History Taking / Q000592:standards; D008875:Middle Aged; D065006:Papanicolaou Test; D011237:Predictive Value of Tests; D012042:Registries; D012044:Regression Analysis; D015203:Reproducibility of Results; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000517:prevention & control; D014626:Vaginal Smears / Q000592:standards / Q000706:statistics & numerical data*