title: Osteopenia and osteoporosis can be predicted from Pap test.
abstract: OBJECTIVE
  To determine sensitivity and specificity of Pap tests for osteopenia and osteoporosis using bone mineral density (BMD) with dual x-ray absorptiometry (DXA) as the reference standard.
  
  
  METHODS
  DXA measurement was performed on 136 routine Pap smears. Results of DXA measurement were expressed in T-scores, indicating degree of deviation compared to a young adult population of same age and gender. Smears were grouped into atrophic and mature cell patterns. Using a stereologic analysis, mean areas of squamous cells, their nuclei and their cytoplasm were estimated.
  
  
  RESULTS
  There was significant positive correlation between cell area and T-score (p < 0.001), as well as between cytoplasm area and T-score (p < 0.001). There was no significant relationship between nucleus area and T-score (p > 0.05). Mean T-scores of patients with atrophic cells were significantly lower than mean T-scores of patients with mature cell patterns (p < 0.001). The group including patients with atrophic or mature cells had a sensitivity of 61.4% and specificity of 86.4%, with positive predictive value of 95.9% in detecting patients with osteopenia or osteoporosis.
  
  
  CONCLUSIONS
  Women with atrophic smear pattern are susceptible to osteopenia or osteoporosis; many cases could be detected with routine Pap test without additional costs.
authors.affiliation: Department of Pathomorphology and Cytology, Celje General Hospital, Celje, Slovenia. alenka.repse-fokter@guest.arnes.si
authors.forename: Alenka
authors.initials: A
authors.lastname: Repse-Fokter
authors.forename: Samo K
authors.initials: SK
authors.lastname: Fokter
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000328:Adult; D000368:Aged; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis; D065006:Papanicolaou Test; D014626:Vaginal Smears / Q000379:methods