title: [Cervical Pap smear in an epidemiologically exposed population: ideas, facts and arguments].
abstract: OBJECTIVE
  To analyse the prevalence of abnormal papsmears in a primary care center and the screening practices.
  
  
  METHODS
  Single-center retrospective study on 1,430 FCU performed in 1,251 patients between January 2009 and December 2011 with analysis of demographic, clinical and epidemiological chararacteristics of the women, and the monitoring of the patients with pathological papsmears.
  
  
  RESULTS
  The study population was predominantly young (under 25), unmarried, nulliparous, and using contraception. Among the 1,244 FCU, nearly 90% of them were interpretable with the junction area interested. Nine percent were pathological with mainly ASC-US and L-SIL (3.5% and 4.5%) with no difference between more and less than 25years. Two factors were significantly associated with the presence of pathological papsmear: first intercourse before age 14 and smoking more than 10 cigarettes per day. Monitoring of patients with a pathological papsmear showed that 33% of patients had not an appropriate follow-up especially younger patients.
  
  
  CONCLUSIONS
  To perform papsmear before 25 years because the patient has associated high risk HPV co-factors does not appear justified by the severity or frequency of cytological lesions, especially as it increases the financial cost and is responsible of potential deleterious actions such as conizations probably excessive among the youngest patients. Personalized monitoring of these patients with a pathological papsmear is required. The French practice recommendations on cervical cancer screening (first screening at age 25, 26 years cytological control then every 3 years up to 65 years in patients who have or have had sex) deserve to be applied in young and disadvantaged patients.
authors: Planning familial de Rennes, 11, boulevard du Maréchal-de-Lattre-de-Tassigny, 35000 Rennes, France.
authors: B
authors: B
authors: Doris
authors: Planning familial de Rennes, 11, boulevard du Maréchal-de-Lattre-de-Tassigny, 35000 Rennes, France; Service de gynécologie, CHU Anne de Bretagne, BP 90 347, 35203 Rennes cedex 2, France.
authors: L
authors: L
authors: Boyer
authors: Service de gynécologie, CHU Anne de Bretagne, BP 90 347, 35203 Rennes cedex 2, France.
authors: V
authors: V
authors: Lavoué
authors: Service d'épidémiologie et santé publique, CHU Pontchaillou, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France.
authors: F
authors: F
authors: Riou
authors: Service d'anatomie et cytologie pathologiques, CHU Pontchaillou, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France.
authors: S
authors: S
authors: Henno
authors: Service d'anatomie et cytologie pathologiques, CHU Pontchaillou, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France.
authors: P
authors: P
authors: Tas
authors: Planning familial de Rennes, 11, boulevard du Maréchal-de-Lattre-de-Tassigny, 35000 Rennes, France.
authors: L
authors: L
authors: Sévène
authors: Service de gynécologie, CHU Anne de Bretagne, BP 90 347, 35203 Rennes cedex 2, France. Electronic address: jean.leveque@chu-rennes.fr.
authors: J
authors: J
authors: Levêque
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test / Q000706:statistics & numerical data*; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D014611:Vaccination / Q000706:statistics & numerical data; D014626:Vaginal Smears / Q000706:statistics & numerical data*; D035862:Vulnerable Populations / Q000706:statistics & numerical data; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control
keywords: Dépistage; Frottis cervico-utérin; Low-income population; Papsmear; Population défavorisée; Screening; Young age; Âge jeune