Original researchLiquid-based Papanicolaou smears without a transformation zone component: should clinicians worry?☆
Section snippets
Materials and methods
The population consisted of women attending three Planned Parenthood of Western Washington clinics between 1997 and 2001. Informed consent was obtained from all study participants. The study protocol was approved by the Institutional Review Board of the University of Washington. Women who were pregnant, chronically immune impaired, without a cervix, or had prior treatment for cervical neoplasia (including electrocautery, cryocautery, conization, laser surgery, or loop electrosurgical excision
Results
During the first 4 years of the study, 4389 women aged 18–50 were screened (mean age 25.2 years). Overall, 700 smears (15.9%) lacked a transformation zone component. The possibility that patient’s age, current OC use, abnormal Papanicolaou history, time since last menstrual period, gravidity, lifetime number of male sex partners, and douching or vaginal medication use might influence the collection of cells from the transformation zone was considered (Table 1). The percentage of transformation
Discussion
Several studies have reported that, in comparison to a conventional Papanicolaou smear, the ThinPrep Papanicolaou test is more likely to be classified as “satisfactory but limited” because of the absence of a transformation zone component, with estimates of this finding ranging from 9.8%12 to 20.0%.13 In our study, 15.9% of screening ThinPrep smears lacked a transformation zone component. However, absence of a transformation zone component did not compromise cytologic-based detection of
Acknowledgements
We thank Tiffany Harris for assistance with project management, Alison Starling and Akhila Balasubramanian for data management, and Kim Tomlinson, Nicole Cosentino, Shanda Bush, Kristin Jay, Emily Woodburne, and Sandra Reilley for their clinical work on this project.
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The Utility of Blind Pap Tests in Young Adults with Developmental Delay: A Pilot Study
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Cytology
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2007, Mayo Clinic ProceedingsCitation Excerpt :Another histologic subtype, adenocarcinoma, arises in the mucous-secreting epithelium of the endocervix. The cytologic screening of cervical epithelium has improved throughout the years,20 and liquid-based cytologic screening and reflex HPV testing at 3-year intervals in sexually active women have been shown to have a sensitivity of 80% and a specificity of 95%, at a cost of approximately $50,000 per year of life saved.21 Current recommendations advise initiating Pap testing 3 years after first intercourse with continued screening at 1- to 3-year intervals, depending on age, risk factors, and the specific guideline being used.22
Human papillomavirus DNA detection in ThinPrep Pap test vials is independent of cytologic sampling of the transformation zone
2007, Gynecologic OncologyCitation Excerpt :Accordingly, the methods used in this study represent the first report on this topic employing FDA-approved test methods currently most widely used in the U.S. for both LBC and hrHPV DNA testing [43]. Baer et al reported in 2002 that 13.7% of patients with the absence of a TZ/ECS and 19.7% of patients with a TZ/ECS were positive for hrHPV DNA using PCR methodology [19]; however, this study did not report the extent to which the older age and lower abnormal cytology rate also noted in their patients with no EZ/TZS may have contributed to this difference. Longitudinal follow-up of our HC2 hrHPV DNA cytology negative patients with and without a TZ/ECS is planned to further characterize the relative risk of women in these two groups for development and detection of cervical neoplasia over time.
HPV information needs
2006, Best Practice and Research: Clinical Obstetrics and Gynaecology
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This study was supported in part by grant CA34493 from the National Cancer Institute and the STD/AIDS Predoctoral and Postdoctoral Training Program (NIAID AI0714P).