High‐grade cervical abnormality following the cytologic diagnosis of atypical endocervical cells of undetermined significance: a retrospective study of 1736 cases

Aime Munro, Vincent Williams, James Semmens, Yee Leung, Colin Stewart, Jim Codde, Katrina Spilsbury, Nerida Steel, Paul Cohen, Peter O'Leary

Research output: Contribution to journalAbstract/Meeting Abstract

Abstract

Background: Atypical endocervical cells (AEC) or glandular cells (AGC) of
undetermined significance is a rare cytology finding (less than 1% of Australian
cervical cytology test results). Previous studies have reported patients
with this test result to be at high-risk (17%-59%) for premalignant and
malignant cervical disease.
Aim: To determine the incidence of histologically confirmed high-grade
cervical abnormalities and to investigate clinical practice in patients presenting
with atypical endocervical cells of undetermined significance (AEC) on
cervical cytology.
Methods: This is a 12 year population-based retrospective study examining
the prevalence, clinical management and outcomes of patients with AEC on
a screening cervical smear. Time to event analysis was used to predict the
odds of having or developing in situ and invasive cervical neoplasia.
Results: AEC were reported in index smears from 0.2% patients (1736/
795421) during the study period. One hundred thirty nine patients (8.0%)
had, or subsequently developed, a high grade cervical lesion. The relative
hazard rate of biopsy confirmed high-grade cervical abnormality was five
times greater in patients aged 25 to 34 years compared to patients aged
45–54 years (odds ratio 5.3; 95% CI 2.9–9.6). Overall, 55.1% of patients
underwent evaluation by a specialist obstetrician/ gynecologist with a positive
trend in compliance following the implementation of revised management
guidelines. The positive predictive value of a high-grade cervical
abnormality in patients with AEC increased during the review period.
Conclusions: Cytologic demonstration of AEC requires careful gynaecologic
evaluation particularly in younger patients with no cervical screening
history and/or having a previously detected low-grade cervical dysplasia.
Original languageEnglish
Article number1168
Pages (from-to)240-240
Number of pages1
JournalAsia–Pacific Journal of Clinical Oncology
Volume10
Issue numberS9
DOIs
Publication statusPublished - 2014

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Retrospective Studies
Cell Biology
Uterine Cervical Dysplasia
Vaginal Smears
Compliance
Odds Ratio
Biopsy
Incidence
Population
Neoplasms

Cite this

@article{88b1c8cb73574ffda7649fd00d34a3b8,
title = "High‐grade cervical abnormality following the cytologic diagnosis of atypical endocervical cells of undetermined significance: a retrospective study of 1736 cases",
abstract = "Background: Atypical endocervical cells (AEC) or glandular cells (AGC) ofundetermined significance is a rare cytology finding (less than 1{\%} of Australiancervical cytology test results). Previous studies have reported patientswith this test result to be at high-risk (17{\%}-59{\%}) for premalignant andmalignant cervical disease.Aim: To determine the incidence of histologically confirmed high-gradecervical abnormalities and to investigate clinical practice in patients presentingwith atypical endocervical cells of undetermined significance (AEC) oncervical cytology.Methods: This is a 12 year population-based retrospective study examiningthe prevalence, clinical management and outcomes of patients with AEC ona screening cervical smear. Time to event analysis was used to predict theodds of having or developing in situ and invasive cervical neoplasia.Results: AEC were reported in index smears from 0.2{\%} patients (1736/795421) during the study period. One hundred thirty nine patients (8.0{\%})had, or subsequently developed, a high grade cervical lesion. The relativehazard rate of biopsy confirmed high-grade cervical abnormality was fivetimes greater in patients aged 25 to 34 years compared to patients aged45–54 years (odds ratio 5.3; 95{\%} CI 2.9–9.6). Overall, 55.1{\%} of patientsunderwent evaluation by a specialist obstetrician/ gynecologist with a positivetrend in compliance following the implementation of revised managementguidelines. The positive predictive value of a high-grade cervicalabnormality in patients with AEC increased during the review period.Conclusions: Cytologic demonstration of AEC requires careful gynaecologicevaluation particularly in younger patients with no cervical screeninghistory and/or having a previously detected low-grade cervical dysplasia.",
author = "Aime Munro and Vincent Williams and James Semmens and Yee Leung and Colin Stewart and Jim Codde and Katrina Spilsbury and Nerida Steel and Paul Cohen and Peter O'Leary",
year = "2014",
doi = "10.1111/ajco.12332",
language = "English",
volume = "10",
pages = "240--240",
journal = "Asia–Pacific Journal of Clinical Oncology",
issn = "1743-7555",
publisher = "John Wiley & Sons",
number = "S9",

}

High‐grade cervical abnormality following the cytologic diagnosis of atypical endocervical cells of undetermined significance : a retrospective study of 1736 cases. / Munro, Aime; Williams, Vincent; Semmens, James; Leung, Yee; Stewart, Colin; Codde, Jim; Spilsbury, Katrina; Steel, Nerida; Cohen, Paul; O'Leary, Peter.

In: Asia–Pacific Journal of Clinical Oncology, Vol. 10, No. S9, 1168, 2014, p. 240-240.

Research output: Contribution to journalAbstract/Meeting Abstract

TY - JOUR

T1 - High‐grade cervical abnormality following the cytologic diagnosis of atypical endocervical cells of undetermined significance

T2 - a retrospective study of 1736 cases

AU - Munro, Aime

AU - Williams, Vincent

AU - Semmens, James

AU - Leung, Yee

AU - Stewart, Colin

AU - Codde, Jim

AU - Spilsbury, Katrina

AU - Steel, Nerida

AU - Cohen, Paul

AU - O'Leary, Peter

PY - 2014

Y1 - 2014

N2 - Background: Atypical endocervical cells (AEC) or glandular cells (AGC) ofundetermined significance is a rare cytology finding (less than 1% of Australiancervical cytology test results). Previous studies have reported patientswith this test result to be at high-risk (17%-59%) for premalignant andmalignant cervical disease.Aim: To determine the incidence of histologically confirmed high-gradecervical abnormalities and to investigate clinical practice in patients presentingwith atypical endocervical cells of undetermined significance (AEC) oncervical cytology.Methods: This is a 12 year population-based retrospective study examiningthe prevalence, clinical management and outcomes of patients with AEC ona screening cervical smear. Time to event analysis was used to predict theodds of having or developing in situ and invasive cervical neoplasia.Results: AEC were reported in index smears from 0.2% patients (1736/795421) during the study period. One hundred thirty nine patients (8.0%)had, or subsequently developed, a high grade cervical lesion. The relativehazard rate of biopsy confirmed high-grade cervical abnormality was fivetimes greater in patients aged 25 to 34 years compared to patients aged45–54 years (odds ratio 5.3; 95% CI 2.9–9.6). Overall, 55.1% of patientsunderwent evaluation by a specialist obstetrician/ gynecologist with a positivetrend in compliance following the implementation of revised managementguidelines. The positive predictive value of a high-grade cervicalabnormality in patients with AEC increased during the review period.Conclusions: Cytologic demonstration of AEC requires careful gynaecologicevaluation particularly in younger patients with no cervical screeninghistory and/or having a previously detected low-grade cervical dysplasia.

AB - Background: Atypical endocervical cells (AEC) or glandular cells (AGC) ofundetermined significance is a rare cytology finding (less than 1% of Australiancervical cytology test results). Previous studies have reported patientswith this test result to be at high-risk (17%-59%) for premalignant andmalignant cervical disease.Aim: To determine the incidence of histologically confirmed high-gradecervical abnormalities and to investigate clinical practice in patients presentingwith atypical endocervical cells of undetermined significance (AEC) oncervical cytology.Methods: This is a 12 year population-based retrospective study examiningthe prevalence, clinical management and outcomes of patients with AEC ona screening cervical smear. Time to event analysis was used to predict theodds of having or developing in situ and invasive cervical neoplasia.Results: AEC were reported in index smears from 0.2% patients (1736/795421) during the study period. One hundred thirty nine patients (8.0%)had, or subsequently developed, a high grade cervical lesion. The relativehazard rate of biopsy confirmed high-grade cervical abnormality was fivetimes greater in patients aged 25 to 34 years compared to patients aged45–54 years (odds ratio 5.3; 95% CI 2.9–9.6). Overall, 55.1% of patientsunderwent evaluation by a specialist obstetrician/ gynecologist with a positivetrend in compliance following the implementation of revised managementguidelines. The positive predictive value of a high-grade cervicalabnormality in patients with AEC increased during the review period.Conclusions: Cytologic demonstration of AEC requires careful gynaecologicevaluation particularly in younger patients with no cervical screeninghistory and/or having a previously detected low-grade cervical dysplasia.

U2 - 10.1111/ajco.12332

DO - 10.1111/ajco.12332

M3 - Abstract/Meeting Abstract

VL - 10

SP - 240

EP - 240

JO - Asia–Pacific Journal of Clinical Oncology

JF - Asia–Pacific Journal of Clinical Oncology

SN - 1743-7555

IS - S9

M1 - 1168

ER -