title: Right-sided ectocervical lesions may be associated with false-negative cytology among women with histologic cervical intraepithelial neoplasia 2 or 3.
abstract: BACKGROUND
  The association between the location of an ectocervical lesion and the sensibility of cytologic screening has not been adequately evaluated.
  
  
  METHODS
  We evaluated the proportion of false-negative cytologic interpretations using three independent cytologic interpretations (conventional, PapNet, and ThinPrep) according to lesion location in 111 women with histologic cervical intraepithelial neoplasia 2 or 3 of a population-based study of cervical neoplasia conducted in Guanacaste, Costa Rica. Semiquantitative measures of human papillomavirus viral load were also considered.
  
  
  RESULTS
  Lesions on a women's right ectocervix were associated with more frequent false-negative results than lesions on left ectocervix for each of the cytologic methods or when the most severe interpretation was considered (p = .004). Right-sided lesions had nonsignificantly lower viral loads than left-sided lesions (p = .2).
  
  
  CONCLUSIONS
  Cervical intraepithelial neoplasia 2 or 3 located on the right side of the cervix may be poorly sampled with broom samplers in some settings, resulting in false-negative cytologic results.
authors.affiliation: Division of Cancer Epidemiology and Genetics, The National Cancer Institute, Rockville, MD 20892, USA. guibovij@mail.nih.gov
authors.forename: Jose
authors.initials: J
authors.lastname: Jeronimo
authors.forename: Philip E
authors.initials: PE
authors.lastname: Castle
authors.forename: Rolando
authors.initials: R
authors.lastname: Herrero
authors.forename: Mark E
authors.initials: ME
authors.lastname: Sherman
authors.forename: M Concepcion
authors.initials: MC
authors.lastname: Bratti
authors.forename: Allan
authors.initials: A
authors.lastname: Hildesheim
authors.forename: Mario
authors.initials: M
authors.lastname: Alfaro
authors.forename: Jorge
authors.initials: J
authors.lastname: Morales
authors.forename: Martha L
authors.initials: ML
authors.lastname: Hutchinson
authors.forename: Robert D
authors.initials: RD
authors.lastname: Burk
authors.forename: Attila
authors.initials: A
authors.lastname: Lorincz
authors.forename: Sholom
authors.initials: S
authors.lastname: Wacholder
authors.forename: Ana Cecilia
authors.initials: AC
authors.lastname: Rodríguez
authors.forename: Mark
authors.initials: M
authors.lastname: Schiffman