Dysplasia and carcinoma in situ of the uterine cervix: prevalence in very young women (under age 22). A one-year study in a health plan population.

An increased number of cervical epithelial abnormalities has been observed in women up to and including 21 years of age. The prevalence and incidence of dysplasia in adolescents and young women is increasing at a time when the incidence of cervical carcinoma is decreasing. We studied 247 women under age 22 with "other than negative" cytologic diagnoses identified during a one-year period (1973) in which approximately 27,500 women in this age group were screened. The prevalence rates of "other than negative" cytology and "other than negative" cytology with confirmed histopathologic abnormalities were 9/1,000 and 2.7/1,000, respectively. Repeat smears and/or tissue speciments were obtained in over 70 per cent of these cases. The majority of abnormalities identified were mild or moderate dysplasia; however eight severe dysplasias and three carcinomas in situ were identified. Fifty-nine percent of these women had a history of one or more pregnancies. Our findings emphasize the presence of dysplasia and carcinoma in situ in young women and suggest the need for re-evaluation of the age at which initiation of the Papanicolaou smear should be considered.