Premium
Effect of 2 referral intervals on diagnostic discordance between cytology and histology at a colposcopy clinic
Author(s) -
Saayman Francois,
Van Gelderen Cyril J.,
Michelow Pam,
Van Den Berg Eunice J.,
Adam Yasmin
Publication year - 2013
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2012.09.022
Subject(s) - medicine , colposcopy , squamous intraepithelial lesion , cytology , dysplasia , obstetrics , gynecology , referral , histology , odds ratio , cervical cancer , cervical intraepithelial neoplasia , cancer , pathology , family medicine
Abstract Objective To determine the effect of the time interval between cervical cytology screening and histology at treatment on grade of cervical disease. Methods In a retrospective cross‐sectional study at a colposcopy clinic in Soweto, Johannesburg, South Africa, data were compared from women with cytologic abnormalities referred for colposcopy between April 2003 and June 2010 to determine whether early (≤ 180 days) or late (> 180 days) referral had an impact on dysplasia grade. Results In the early and late referral groups, there were 213 (13.43%) and 201 (14.63%) women, respectively, with upgrading of cervical dysplasia ( P = 0.35), and 1373 (86.57%) and 1173 (85.37%) women, respectively, with downgrading or no change ( P = 0.35). Risk factors for upgrading were HIV infection (odds ratio [OR], 1.63; P < 0.001) and condom use (OR, 1.30; P = 0.02). Four cases (0.68%) of invasion among women with low‐grade squamous intraepithelial lesion (LSIL) and 50 cases (2.11%) among women with high‐grade SIL (HSIL) were not detected by cytology. Risk factors for invasive disease on histology were age (OR, 1.09 per year; P < 0.001), parity (OR, 1.32 per pregnancy; P < 0.001), and HSIL on cytology (OR, 3.17; P = 0.03). Conclusion There was no difference in the up‐ or downgrading of cervical dysplasia between the 2 referral groups.