title: Potential effects of updated pap test screening guidelines and adenocarcinoma in situ of the cervix.
abstract: OBJECTIVE
  To review cases of adenocarcinoma in situ (AIS) at our institution to examine how updated guidelines affect the timing of diagnosis.
  
  
  METHODS
  We identified patients with AIS diagnosed between 1998 and 2010 using the International Classification of Diseases, 9 Revision, Clinical Modification, code 233.1. Diagnosis was confirmed by pathology review. We abstracted demographic data, dysplasia history, and modalities utilized for diagnosis and treatment.
  
  
  RESULTS
  We identified 242 patients who met selection criteria. Two hundred eight (86%) had Pap test abnormalities at presentation. One hundred thirty-seven out of 208 (66%) patients with abnormal Pap test results had a squamous, rather than glandular, abnormality. The mean time from abnormal Pap test to diagnosis of AIS was 29 months in patients older than 30 years and was 21 months in patients 30 years or younger. In patients younger than 21 years, 16 out of 17 had abnormal screening Pap test results showing squamous lesions. Their subsequent treatment for squamous dysplasia ultimately led to the diagnosis of AIS.
  
  
  CONCLUSIONS
  : Updated screening guidelines may prevent the expeditious diagnosis of AIS in females younger than 21 years and those aged 21-29 years, many of whom had normal Pap test results within 3 years of diagnosis.
  
  
  METHODS
  II.
authors: University of Wisconsin, Madison, Wisconsin; Brigham and Women's Hospital and Dana Farber Cancer Institute, Boston, Massachusetts; and Academisch Medisch Centrum, University of Amsterdam, Amsterdam, the Netherlands.
authors: Lisa
authors: L
authors: Barroilhet
authors: Lennie
authors: L
authors: Van Hanegem
authors: Marilyn
authors: M
authors: Bernstein
authors: Sarah
authors: S
authors: Feldman
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D014626:Vaginal Smears / Q000592:standards*; D055815:Young Adult
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