Outcome after a cytological prediction of glandular abnormality.

BACKGROUND

The National Health and Medical Research Council of Australia Guidelines for the Management of Women with Screen Detected Abnormalities are under review. The availability of population-based Australian data on the outcome after a cytology prediction of glandular abnormality was considered relevant to revising the recommended investigations for women with these abnormalities.

AIM: To describe the outcome of women with cytological predictions of glandular abnormalities of the cervix during 1999.

METHODS

A longitudinal study using data held by the Pap Test Registers of Australia.

RESULTS

Over a 24 month period, 70% (95% confidence interval (CI) 62-78%) of women whose cytology was reported as adenocarcinoma in situ (AIS) were confirmed as having high-grade disease. Among women whose cytology was reported as 'inconclusive: possible high-grade glandular disease', the proportion of women having high-grade disease was 25% (95% CI 20-30%). For cytology reports of minor non-specific change (MNSC) of glandular cells, the proportion of women having high-grade disease was 10% (95% CI 8-12%). Cancer was diagnosed in 16%, 5% and <1% of women with index cytology reports of AIS, inconclusive and MNSC, respectively.

CONCLUSIONS

These results can be used to inform an evidence-based approach to the investigation and management of abnormal glandular cytology reports. The results can also be used to better inform women about the significance of their abnormal cytology.