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How frequently need vaginal smears be taken after hysterectomy for cervical intraepithelial neoplasia?
Author(s) -
GEMMELL J.,
HOLMES D. M.,
DUNCAN I. D.
Publication year - 1990
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1990.tb01717.x
Subject(s) - medicine , cervical intraepithelial neoplasia , hysterectomy , vaginal smear , cytology , intraepithelial neoplasia , gynecology , obstetrics , retrospective cohort study , cervical cancer , cancer , surgery , pathology , prostate , estrous cycle
Summary. A retrospective longitudinal review identified 341 women who had had a hysterectomy in association with CIN 3, in Tayside Region, during the ycars 1967–1977; 219 (64%) had completed l0 years of cytology follow‐up and of 140 women eligible for 15‐year smears 79 (56%) completed the 15‐year follow‐up. Eight (4%) of the 219 patients developed abnormal cytology, but in six, smears reverted to normal spontaneously. Two patients had persistently abnormal smears and vaginal intraepithelial neoplasia (VAIN) was diagnosed. Only one patient completing 15‐year follow‐up had an abnormal smear and VAIN later diagnosed. No patient over this 15‐year period developed invasive vaginal carcinoma. Sixty vaginal carcinomas were identified during the period 1957–1987 from the gynaecology cancer register; only one was associated with a previous diagnosis of CIN 3 at hysterectomy. With such data we would propose screening 6‐monthly during the first postoperative year and then at 2 years. If these smears were normal, the patient could then revert to the normal screening programme.