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Type: Artigo de periódico
Title: High-Grade Squamous Intraepithelial Lesion in Women Aged < 30 Years Has a Prevalence Pattern Resembling Low-Grade Squamous Intraepithelial Lesion
Author: Vale, DB
Westin, MC
Zeferino, LC
Abstract: BACKGROUNDCervical cytology is the cervical cancer screening test for women aged <30 years because of the low specificity of human papillomavirus tests in this age group. The Bethesda System classifies cervical intraepithelial neoplasia grade 2 (CIN 2) and grade 3 (CIN 3) as high-grade intraepithelial lesions (HSIL). In this study, the authors subclassified cytologic HSIL as suggestive of CIN 2 (HSIL-CIN 2) or CIN 3 (HSIL-CIN 3) and evaluated whether there was a correlation between these findings and age for screened and unscreened women. METHODSThe study included 2,002,472 cervical smears collected from women who had at least 1 previous test (screened) and 217,826 previously untested women (unscreened). The laboratory has been using the Bethesda System since 1998 with the subcategorization of HSIL-CIN 2 and HSIL-CIN 3. RESULTSFor unscreened women, the prevalence of low-grade intraepithelial lesion (LSIL) and HSIL-CIN 2 decreased with age, whereas the prevalence of HSIL-CIN 3 increased. The prevalence of HSIL-CIN 2 was greater than that of HSIL-CIN 3 for women up to age 29 years (prevalence ratio [PR], 4.73; 95% confidence interval [CI], 3.90-5.75) and lower for the groups ages 30 to 49 years (PR, 0.66; 95% CI, 0.50-0.87) and 50 years (PR, 0.21; 95% CI, 0.12-0.36). For screened women, the prevalence of HSIL-CIN 2 also was greater in the group aged 29 years (PR, 2.72; 95% CI, 2.49-2.97). CONCLUSIONSThe prevalence pattern of HSIL suggestive of CIN 2 resembled the pattern observed in LSIL and was more prevalent than HSIL suggestive of CIN 3 in younger women. The impact of screening was less evident when HSIL was suggestive of CIN 2. A conservative approach for younger women who have HSIL is important for management guidance. Cancer (Cancer Cytopathol) 2013;121:576-581. (c) 2013 American Cancer Society. The prevalence pattern of high-grade squamous intraepithelial lesion (HSIL) suggestive of cervical intraepithelial neoplasia grade 2 (CIN 2) resembles the pattern observed in low-grade squamous intraepithelial lesion and is more prevalent than HSIL suggestive of CIN 3 in younger women. The impact of screening is less evident when HSIL is suggestive of CIN 2.
Subject: screening
uterine cervical neoplasms
cervical intraepithelial neoplasm
human papillomavirus
cervical smear
Country: EUA
Editor: Wiley-blackwell
Citation: Cancer Cytopathology. Wiley-blackwell, v. 121, n. 10, n. 576, n. 581, 2013.
Rights: fechado
Identifier DOI: 10.1002/cncy.21312
Date Issue: 2013
Appears in Collections:Unicamp - Artigos e Outros Documentos

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