Revised Pap Guidelines Delay Diagnosis of Adenocarcinoma in Young Women
New Pap Guidelines May Delay Adenocarcinoma Diagnosis
(HealthDay News) -- Recent revisions in national guidelines for cervical cancer screening may affect clinicians' ability to diagnosis adenocarcinoma in situ (AIS), particularly in young patients, according to a study published online March 6 in Obstetrics & Gynecology.
Lisa Barroilhet, M.D., from the University of Wisconsin in Madison, and colleagues identified 242 patients with AIS diagnosed between 1998 and 2010 using the International Classification of Diseases, 9th Revision, Clinical Modification, code 233.1. Pathology review confirmed diagnosis. Medical records were used to identify demographic data, dysplasia history, and modalities utilized for diagnosis and treatment.
The researchers found that 208 (86 percent) had Pap test abnormalities at presentation. Out of 208 patients with abnormal Pap test results, 137 (66 percent) patients had a squamous, rather than glandular, abnormality. From abnormal Pap test to diagnosis of AIS, the mean time was 29 months in patients older than 30 years and was 21 months in patients 30 years or younger. In patients younger than 21 years, squamous lesions were seen in 16 out of 17 abnormal screening Pap test results.
"Updated screening guidelines may prevent the expeditious diagnosis of AIS in females younger than 21 years and those aged 21 to 29 years, many of whom had normal Pap test results within three years of diagnosis," the authors write.