title: Age-related changes in the diagnostic assessment of women with severe cervical lesions.
abstract: OBJECTIVE
  To evaluate the effect of age on the diagnostic assessment of women with severe cervical intraepithelial neoplasia (CIN).
  
  
  METHODS
  This retrospective observational study included 338 consecutive women with a diagnosis of CIN3 on cone specimen. Patients were divided into three groups according to age: < 35 years (Group A), 35-49 years (Group B), and ≥ 50 years (Group C). Clinical and colposcopic variables were compared, and human papillomavirus (HPV) genotype distribution was measured.
  
  
  RESULTS
  The most common HPV genotype was HPV-16 (63.65%), followed by HPV-33 (7%), HPV-18 (6.2%), and HPV-31 (5.4%). The rate of the following high-grade lesion predictors was lower in Group C than in Groups A and B: HPV-16 infections (55.9% vs. 75% vs. 70.9%, respectively, p = 0.022); high-grade colposcopic impression (29.4% vs. 51.8% vs. 51.7%, respectively, p < 0.0001); and high-grade cytological changes (30.9% vs. 56.2% vs. 45.4%, respectively, p = 0.025). An endocervical lesion location was more frequent in Group C than in Groups A and B (55.6% vs. 6.8% vs. 11.8%, respectively, p < 0.0001).
  
  
  CONCLUSIONS
  Women aged 50 years and older with CIN3 showed a significant reduction of high-grade lesion predictors along with physiological confounding cervical changes (transformation zone type 3 and endocervical lesion location). The diagnostic work-up of cervical lesions in older women should provide their potential consideration as a special population.
authors.affiliation: * Local Health Authority of Reggio Emilia, Division of Obstetrics and Gynecology, Cesare Magati Hospital , Scandiano , Italy.
authors.forename: L
authors.initials: L
authors.lastname: Giannella
authors.forename: C
authors.initials: C
authors.lastname: Fodero
authors.forename: F
authors.initials: F
authors.lastname: Boselli
authors.forename: K
authors.initials: K
authors.lastname: Mfuta
authors.forename: T
authors.initials: T
authors.lastname: Rubino
authors.forename: S
authors.initials: S
authors.lastname: Prandi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003127:Colposcopy; D004279:DNA, Viral / Q000032:analysis / Q000302:isolation & purification; D005260:Female; D005838:Genotype; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification; D012189:Retrospective Studies; D012720:Severity of Illness Index; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000821:virology; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000821:virology
chemical_list: D004279:DNA, Viral
keywords: AGE; CERVICAL INTRAEPITHELIAL NEOPLASIA; CIN3; DIAGNOSTIC ASSESSMENT; OLDER WOMEN; SEVERE CERVICAL DYSPLASIA