title: Association between concurrent genital bleeding and cervical cancer: a cross-sectional study.
abstract: BACKGROUND
  Genital bleeding may be a common symptom among women with cervical cancer.
  
  
  METHODS
  Cross-sectional study evaluating whether the prevalence of cervical smear results is different in women with and without clinical information about concurrent genital bleeding.
  
  
  RESULTS
  The sample consisted of 2 324 836 smears; of these, 0.4% had clinical information on genital bleeding. When stratified by age group, women with genital bleeding had a higher chance of a cytological result of a high-grade squamous intraepithelial lesion [30-49 years odds ratio (OR) 2.38; 95% confidence interval (CI) 1.60-3.53 and ≥50 years OR 6.30; 95%CI 3.72-10.67), of squamous cell carcinoma (SCC) (30-49 years OR 24.70; 95%CI 11.96-51.03 and ≥50 years OR 48.91; 95%CI 31.28-76.47) and of atypical glandular cells (30-49 years OR 5.72; 95%CI 3.30-9.93 and ≥50 years OR 11.56; 95%CI 5.96-22.45); there was also a higher chance of adenocarcinoma for women ≥50 years (OR 53.13; 95%CI 28.08-100.51). The sensitivity of genital bleeding for women aged 18-29 years was 0.4% for high-grade squamous intraepithelial lesion (HSIL); for women 30-49 years old the rate was 0.9% for HSIL, 8.6% for SCC and 2.1% for atypical glandular cells of undetermined significance (AGUS), while for women aged from 50 years or more the rates were 2.0% for HSIL, 13.7% for SCC, 3.6% for AGUS and 14.7% for adenocarcinoma.
  
  
  CONCLUSIONS
  Women ≥30 years old with genital bleeding should be referred for colposcopy to rule out the possibility of cervical cancer.
authors.affiliation: Pathology Department, Paulista State University (UNESP), Botucatu, Brazil.
authors.forename: José C C
authors.initials: JC
authors.lastname: Xavier-Júnior
authors.affiliation: Department of Gynecology and Obstetrics, Campinas State University (UNICAMP), Campinas, Brazil.
authors.forename: Diama B
authors.initials: DB
authors.lastname: Vale
authors.affiliation: Department of Gynecology and Obstetrics, Campinas State University (UNICAMP), Campinas, Brazil.
authors.forename: Luiz C
authors.initials: LC
authors.lastname: Zeferino
authors.affiliation: Pathology Department, Paulista State University (UNESP), Botucatu, Brazil.
authors.forename: Rozany M
authors.initials: RM
authors.lastname: Dufloth
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D065309:Atypical Squamous Cells of the Cervix; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000473:pathology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D065310:Squamous Intraepithelial Lesions of the Cervix / Q000453:epidemiology* / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology; D014592:Uterine Hemorrhage / Q000150:complications* / Q000473:pathology*; D014626:Vaginal Smears; D055815:Young Adult
keywords: Uterine cervical neoplasms; abnormal uterine bleeding; age; early detection of cancer; papanicolaou test