Age-related changes in the diagnostic assessment of women with severe cervical lesions

L. Giannella, C. Fodero, F. Boselli, K. Mfuta, T. Rubino, S. Prandi

Research output: Contribution to journalArticle

Abstract

Objectives 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). Conclusion 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.

Original languageEnglish
Pages (from-to)617-623
Number of pages7
JournalClimacteric
Volume18
Issue number4
DOIs
Publication statusPublished - Aug 1 2015

Fingerprint

Human papillomavirus 16
Human papillomavirus 31
Genotype
Human papillomavirus 18
Cervical Intraepithelial Neoplasia
Papillomavirus Infections
Observational Studies
Retrospective Studies
Population

Keywords

  • age
  • cervical intraepithelial neoplasia
  • CIN3
  • diagnostic assessment
  • Older women
  • severe cervical dysplasia

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Giannella, L., Fodero, C., Boselli, F., Mfuta, K., Rubino, T., & Prandi, S. (2015). Age-related changes in the diagnostic assessment of women with severe cervical lesions. Climacteric, 18(4), 617-623. https://doi.org/10.3109/13697137.2015.1005592

Age-related changes in the diagnostic assessment of women with severe cervical lesions. / Giannella, L.; Fodero, C.; Boselli, F.; Mfuta, K.; Rubino, T.; Prandi, S.

In: Climacteric, Vol. 18, No. 4, 01.08.2015, p. 617-623.

Research output: Contribution to journalArticle

Giannella, L, Fodero, C, Boselli, F, Mfuta, K, Rubino, T & Prandi, S 2015, 'Age-related changes in the diagnostic assessment of women with severe cervical lesions', Climacteric, vol. 18, no. 4, pp. 617-623. https://doi.org/10.3109/13697137.2015.1005592
Giannella, L. ; Fodero, C. ; Boselli, F. ; Mfuta, K. ; Rubino, T. ; Prandi, S. / Age-related changes in the diagnostic assessment of women with severe cervical lesions. In: Climacteric. 2015 ; Vol. 18, No. 4. pp. 617-623.
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abstract = "Objectives 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). Conclusion 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.",
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N2 - Objectives 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). Conclusion 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.

AB - Objectives 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). Conclusion 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.

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