The relationship between atypical glandular cells of undetermined significance on Pap smear and a clinically significant histologic diagnosis.
OBJECTIVE
To determine whether the cytologic diagnosis of atypical glandular cells of undetermined significance (AGUS) on Pap smear was associated with a clinically significant histologic diagnosis.


METHODS
A retrospective cohort study was performed on the charts of women diagnosed with AGUS on Pap smear in 2 referral colposcopy clinics, between January 1999 and July 2002. The factors considered included age, menstrual status, use of birth control pills or hormone replacement therapy, parity, referral Pap, type of evaluation at colposcopy, histologic diagnosis, and final diagnosis at pathology.


RESULTS
Of the 124 women with a referral diagnosis of AGUS, 41 (33.1%) had significant histology at colposcopy. Premenopausal and nulliparous women were more likely to have a significant histologic diagnosis. The categories of "favour neoplastic" and "favour reactive" were not predictive of significant histology. Menopausal status was not predictive of either endometrial or endocervical disease among serious lesions.


CONCLUSIONS
Because almost one-third of women with the finding of AGUS on Pap smear will have a diagnosis at the time of colposcopy that requires treatment, a colposcopy and endocervical curettage should be recommended to all women with AGUS. The new designation of "atypical glandular cells" (AGC) under the 2001 Bethesda classification system is appropriate, as "favour reactive" and "favour neoplastic" are not predictive of serious histologic findings.
Barreth
Drew
D
Department of Obstetrics and Gynaecology, University of Alberta, Edmonton, AB.
Faught
Wylam
W
Schepansky
Alexandra
A
Johnson
Gordon
G
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology*; D000328:Adult; D000367:Age Factors; D002584:Cervix Uteri / Q000166:cytology / Q000473:pathology*; D015331:Cohort Studies; D003127:Colposcopy; D003581:Cytodiagnosis / Q000379:methods / Q000592:standards*; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D008403:Mass Screening; D008593:Menopause; D008875:Middle Aged; D065006:Papanicolaou Test; D011230:Precancerous Conditions / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology*; D014621:Vagina / Q000166:cytology / Q000473:pathology; D014626:Vaginal Smears / Q000379:methods / Q000592:standards