Risk of gynaecological malignancies in cytologically atypical glandular cells: follow-up study of a nationwide screening population.
OBJECTIVE
To investigate the relationship between screening status, clinical characteristics and risk of gynaecological malignancies in women with a cytological diagnosis of atypical glandular cells (AGC).


METHODS
Prospective study of a screened population.


METHODS
Case series from nationwide screening population.


METHODS
The 8281 women who were diagnosed with cytological AGC for the first time were divided into screened (5386 women) and unscreened (2895 cases) groups according to their screening status. Follow-up histological reports were analysed.


METHODS
Diagnosis of cervical, uterine, or ovarian cancers.


RESULTS
Of the 323 women who developed gynaecological malignancies, 271 had invasive cervical cancers, 40 had uterine cancers and 12 had ovarian cancers, with a mean follow up of 1.9 years and 50 740 person-years. Previous screening status was a strong risk predictor of gynaecological malignancies (hazard ratio 1.69, P = 0.0027). Compared with the general screening population, women with a first diagnosis of cytological AGC had significantly increased ratios of developing gynaecological malignancies (17.85-fold for cervical cancer, 5.68-fold for uterine cancer, and 2.04-fold for ovarian cancer, P < 0.05). When compared with women aged <35 years, those in other age groups had a significantly higher risk of developing gynaecological cancers (age ≥60 years, hazard ratio 1.99, 95% CI 1.20-2.37, P = 0.016).


CONCLUSIONS
Comprehensive evaluation for women with cytological AGC, including pelvic examination, ultrasonography, colposcopy, endocervical curettage, cervical biopsy and endometrial biopsy needs to be considered, especially for those with risk factors (i.e. >60 years old, lower educational status, previous Papanicolaou smear interval longer than 2 years, or no previous Papanicolaou smear).
Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan.
W-F
WF
Cheng
Y-L
YL
Chen
S-L
SL
You
C-J
CJ
Chen
Y-C
YC
Chen
C-Y
CY
Hsieh
C-A
CA
Chen
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005833:Genital Neoplasms, Female / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D015994:Incidence; D008403:Mass Screening; D008875:Middle Aged; D065006:Papanicolaou Test; D011446:Prospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D014626:Vaginal Smears