Risk of CIN2 in women with a Pap test without endocervical cells vs. those with a negative Pap test with endocervical cells: A cohort study with 4.5 years of follow-up

Paolo Giorgi Rossi, Diego Baiocchi, Stefano Ciatto, Paola Cariaggi, Daniela Gustinucci, Ilaria Camilli, Ettore Mancini, Gioia Montanari, Adele Caprioglio, Franca Parisio, Claudio Angeloni, Giannina Di Gabriele, Anna Carantoni, Galliano Tinacci, Mario Matteucci, Graziella Pontani, Guido Collina, Maddalena Carmelo, Patrizia Biavati, Patrizia SchincagliaMonica Serafini, Paolo Dalla Palma, Enzo Polla, Aurora Assunta Scarfantoni, Maria Luisa Schiboni, Emanuela Anghinoni

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To measure the risk of cervical intraepithelial neoplasia grade 2 or higher (CIN2+) in the 4.5 years following a negative Pap smear with adequate endocervical cells (ECC) (+) or absent/scarce ECC (-). Study Design: A prospective, nonconcurrent study of the archives of 11 Italian population-based screening programs was conducted. Only 25-50-year-old women with a first negative Pap test were included. Results: Women were classified as ECC+ or ECC- and followed for 4.5 years. The end point was the occurrence of a CIN2+ histologic diagnosis. Eligible subjects with negative Pap tests ECC+ and ECC- numbered 469,694 and 20,596, respectively. At least 1 subsequent test was available during follow-up for 335,763 and 11,972 subjects, and 691 and 13 CIN2+ lesions were observed, respectively. The risk of CIN2+ was 2.06 and 1.09 per 1,000 women over 4.5 years, and age-adjusted relative risk associated with ECC-was 0.55 (95% CI 0.28-1.06). Conclusion: Women with a negative Pap ECC- have a lower risk of CIN2+ than women with a negative Pap ECC+ and should repeat screening with the current frequency (3-5 years in Europe), independent of age.

Original languageEnglish
Pages (from-to)265-271
Number of pages7
JournalActa Cytologica
Volume54
Issue number3
Publication statusPublished - 2010

Keywords

  • Cervical cancer
  • Endocervical cells
  • Papanicolaou smear

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

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