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Routine vaginal Pap test is not useful in women status‐post hysterectomy for benign disease
Author(s) -
Farghaly Hanan,
Bourgeois Danyel,
Houser Patricia M.,
Padmanabhan Vijaylakshmi,
Lage Janice M.,
Hoda Rana S.
Publication year - 2006
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.20527
Subject(s) - medicine , gynecology , malignancy , squamous intraepithelial lesion , hysterectomy , pap test , ascus (bryozoa) , cervical cancer , cervical intraepithelial neoplasia , disease , obstetrics , cancer , surgery , cervical cancer screening , botany , ascospore , spore , biology
The US Preventive Services Task Force (USPTF) has recommended that routine vaginal Pap (V‐Pap) screening is unnecessary for women status‐post (S/P) total hysterectomy (T‐Hyst) for benign disease (Guide to Clinical Preventive Services. 2nd ed. Baltimore, MD: Williams & Wilkins; 1996. p 105–118). However, many US women continue to have V‐Pap despite no risk for cervical cancer and minimal risk for primary vaginal cancer (JAMA 2004;291:2990). Herein, we report our experience with such patients. Computerized data of patients S/P T‐Hyst for benign conditions over a 6‐yr‐period were retrospectively evaluated. Pap diagnoses of epithelial abnormalities (Ep Abnl), negative for intraepithelial lesion or malignancy with/without nonneoplastic findings (NILM‐NN and NILM), were reviewed based on three age groups: group A, 18–44 yr; group B, 45–64 yr; and group C, ≥65 yr (JAMA 2004;291:2990). A control group was used. Of 1,860 T‐Hyst 1,303 (70%) were for benign disease. Of these 581/1303 (44.5%) patients had 819 current V‐Paps (range, 1–5; mean, 1.4). The 581 patients were group A, 288 (49.5%); group B, 272 (46.8%); and group C, 21 (3.6%). Overall, the 819 V‐Paps showed Ep Abnl, 28 (3.4%); NILM‐NN, 252 (30.7%); and NILM, 539 (65.8%). Of the 28 Ep Abnl, 19 (67.8%) were atypical squamous cells of undetermined significance (ASCUS), and 9 (32%) were low‐grade vaginal intraepithelial lesions (LG‐VAIN). The NILM‐NN findings included organisms, atrophy, and endometriosis. On the basis of individual age groups, Ep Abnl were only seen in V‐Paps of 7/288 (2%) of group A and 21/272 (8%) of group B patients. In 23 control patients, 7/71 (9.8%) current V‐Paps showed Ep Abnl (ASCUS, 4 (57%); LG‐VAIN, 3 (43%)). Continued V‐Pap in women S/P T‐Hyst for benign disease does not appear to be useful, particularly in those aged ≥65 yr. Diagn. Cytopathol. 2006;34:640–643. © 2006 Wiley–Liss, Inc.