Risk of high-grade cervical dysplasia and gynaecological malignancies following the cytologic diagnosis of atypical endocervical cells of undetermined significance: A retrospective study of a state-wide screening population in Western Australia

A. Munro, V. Williams, J. Semmens, Yee Leung, Colin Stewart, J. Codde, K. Spilsbury, N. Steel, Paul Cohen, P. O'Leary

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    3 Citations (Scopus)

    Abstract

    Background: In 2006, Australia adopted a revised cervical cytology terminology system, known as the Australian Modified Bethesda System (AMBS). One substantial change in the AMBS was the introduction of the diagnostic category of atypical endocervical cells (AEC) of undetermined significance. Aim: The aim of this study was to investigate the incidence of histologically confirmed high-grade cervical dysplasia (cervical intra-epithelial neoplasia (CIN) grades 2 and 3 and adenocarcinoma in situ (ACIS)), cervical carcinoma and endometrial carcinoma in women presenting with AEC on cervical cytology. Methods: A seven-year retrospective study examining clinical outcomes of women with AEC on a screening cervical smear. Cytology and histology results were extracted from the Western Australia Cervical Screening Registry, and time-toevent analysis was used to predict the odds of having or developing in situ and invasive neoplasia. Results: AEC was reported in index smears from 0.093% (584/622754) women during the study period. No follow-up was available in 35 AEC cases. Sixty-five of the remaining 549 women (11.8%) had, or developed, high-grade cervical dysplasia within five years of their index AEC diagnosis. Endometrial cancer was diagnosed in 21 women and cervical cancer in four women during the follow-up period. Conclusion: Cytologic demonstration of AEC requires careful gynaecologic evaluation, particularly in younger women who may be found to have either high-grade squamous (CIN) or glandular (ACIS) lesions, while in older women, the possibility of endometrial neoplasia needs to be considered.
    Original languageEnglish
    Pages (from-to)268-273
    JournalThe Australian and New Zealand Journal of Obstetrics and Gynaecology
    Volume55
    Issue number3
    DOIs
    Publication statusPublished - 2015

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    Uterine Cervical Dysplasia
    Western Australia
    Retrospective Studies
    Population
    Neoplasms
    Cell Biology
    Endometrial Neoplasms
    Vaginal Smears
    Terminology
    Uterine Cervical Neoplasms
    Registries
    Histology
    Carcinoma
    Incidence

    Cite this

    @article{adadfc2c34404ee290b76963fc59013b,
    title = "Risk of high-grade cervical dysplasia and gynaecological malignancies following the cytologic diagnosis of atypical endocervical cells of undetermined significance: A retrospective study of a state-wide screening population in Western Australia",
    abstract = "Background: In 2006, Australia adopted a revised cervical cytology terminology system, known as the Australian Modified Bethesda System (AMBS). One substantial change in the AMBS was the introduction of the diagnostic category of atypical endocervical cells (AEC) of undetermined significance. Aim: The aim of this study was to investigate the incidence of histologically confirmed high-grade cervical dysplasia (cervical intra-epithelial neoplasia (CIN) grades 2 and 3 and adenocarcinoma in situ (ACIS)), cervical carcinoma and endometrial carcinoma in women presenting with AEC on cervical cytology. Methods: A seven-year retrospective study examining clinical outcomes of women with AEC on a screening cervical smear. Cytology and histology results were extracted from the Western Australia Cervical Screening Registry, and time-toevent analysis was used to predict the odds of having or developing in situ and invasive neoplasia. Results: AEC was reported in index smears from 0.093{\%} (584/622754) women during the study period. No follow-up was available in 35 AEC cases. Sixty-five of the remaining 549 women (11.8{\%}) had, or developed, high-grade cervical dysplasia within five years of their index AEC diagnosis. Endometrial cancer was diagnosed in 21 women and cervical cancer in four women during the follow-up period. Conclusion: Cytologic demonstration of AEC requires careful gynaecologic evaluation, particularly in younger women who may be found to have either high-grade squamous (CIN) or glandular (ACIS) lesions, while in older women, the possibility of endometrial neoplasia needs to be considered.",
    author = "A. Munro and V. Williams and J. Semmens and Yee Leung and Colin Stewart and J. Codde and K. Spilsbury and N. Steel and Paul Cohen and P. O'Leary",
    year = "2015",
    doi = "10.1111/ajo.12336",
    language = "English",
    volume = "55",
    pages = "268--273",
    journal = "The Australian and New Zealand Journal of Obstetrics and Gynaecology",
    issn = "0004-8666",
    publisher = "John Wiley & Sons, Ltd (10.1111)",
    number = "3",

    }

    TY - JOUR

    T1 - Risk of high-grade cervical dysplasia and gynaecological malignancies following the cytologic diagnosis of atypical endocervical cells of undetermined significance: A retrospective study of a state-wide screening population in Western Australia

    AU - Munro, A.

    AU - Williams, V.

    AU - Semmens, J.

    AU - Leung, Yee

    AU - Stewart, Colin

    AU - Codde, J.

    AU - Spilsbury, K.

    AU - Steel, N.

    AU - Cohen, Paul

    AU - O'Leary, P.

    PY - 2015

    Y1 - 2015

    N2 - Background: In 2006, Australia adopted a revised cervical cytology terminology system, known as the Australian Modified Bethesda System (AMBS). One substantial change in the AMBS was the introduction of the diagnostic category of atypical endocervical cells (AEC) of undetermined significance. Aim: The aim of this study was to investigate the incidence of histologically confirmed high-grade cervical dysplasia (cervical intra-epithelial neoplasia (CIN) grades 2 and 3 and adenocarcinoma in situ (ACIS)), cervical carcinoma and endometrial carcinoma in women presenting with AEC on cervical cytology. Methods: A seven-year retrospective study examining clinical outcomes of women with AEC on a screening cervical smear. Cytology and histology results were extracted from the Western Australia Cervical Screening Registry, and time-toevent analysis was used to predict the odds of having or developing in situ and invasive neoplasia. Results: AEC was reported in index smears from 0.093% (584/622754) women during the study period. No follow-up was available in 35 AEC cases. Sixty-five of the remaining 549 women (11.8%) had, or developed, high-grade cervical dysplasia within five years of their index AEC diagnosis. Endometrial cancer was diagnosed in 21 women and cervical cancer in four women during the follow-up period. Conclusion: Cytologic demonstration of AEC requires careful gynaecologic evaluation, particularly in younger women who may be found to have either high-grade squamous (CIN) or glandular (ACIS) lesions, while in older women, the possibility of endometrial neoplasia needs to be considered.

    AB - Background: In 2006, Australia adopted a revised cervical cytology terminology system, known as the Australian Modified Bethesda System (AMBS). One substantial change in the AMBS was the introduction of the diagnostic category of atypical endocervical cells (AEC) of undetermined significance. Aim: The aim of this study was to investigate the incidence of histologically confirmed high-grade cervical dysplasia (cervical intra-epithelial neoplasia (CIN) grades 2 and 3 and adenocarcinoma in situ (ACIS)), cervical carcinoma and endometrial carcinoma in women presenting with AEC on cervical cytology. Methods: A seven-year retrospective study examining clinical outcomes of women with AEC on a screening cervical smear. Cytology and histology results were extracted from the Western Australia Cervical Screening Registry, and time-toevent analysis was used to predict the odds of having or developing in situ and invasive neoplasia. Results: AEC was reported in index smears from 0.093% (584/622754) women during the study period. No follow-up was available in 35 AEC cases. Sixty-five of the remaining 549 women (11.8%) had, or developed, high-grade cervical dysplasia within five years of their index AEC diagnosis. Endometrial cancer was diagnosed in 21 women and cervical cancer in four women during the follow-up period. Conclusion: Cytologic demonstration of AEC requires careful gynaecologic evaluation, particularly in younger women who may be found to have either high-grade squamous (CIN) or glandular (ACIS) lesions, while in older women, the possibility of endometrial neoplasia needs to be considered.

    U2 - 10.1111/ajo.12336

    DO - 10.1111/ajo.12336

    M3 - Article

    VL - 55

    SP - 268

    EP - 273

    JO - The Australian and New Zealand Journal of Obstetrics and Gynaecology

    JF - The Australian and New Zealand Journal of Obstetrics and Gynaecology

    SN - 0004-8666

    IS - 3

    ER -