The Analysis of Treatments after Further Examination of Cervical Cancer Screening on Bethesda System Classification

Abstract

 Introduction: In April 2011, our facility introduced the liquid-based cytology and Bethesda system classification into the cervical cancer screening. We analyzed 197 examinees who required further examination after the screening from April 2011 to March 2016.

 Methods: We analyzed mainly the replies to the introduction letters about the treatment after the further examination.

 Results: The detection rate of the examinees who required further examination was 1.1% and the rate was higher in younger age groups. The fractions of the examinees who required further examination were ASC-US 37%, LSIL 41%, ASC-H 2%, HSIL 17% and AGC 3%. After further examination, 3 women (25% of ASC-H and 33% of AGC) underwent hysterectomy and 30 women underwent conization (10% of ASC-US, 7% of LSIL, 50% of ASC-H, 42% of HSIL and 17% of AGC). The conization group fractions were ASC-US 23%, LSIL 20%, ASC-H 7%, HSIL 47% and AGC 3%. As to mild cytological abnormalities, LSIL and ASC-US, they account for 43% of those who underwent conization, while the treatment rates were low. The intervals from the screening to the conization were within 6 months in most cases of ASC-H·HSIL·AGC, from 1 year to 2 years in many cases of LSIL and varying from within 3 months to after 4~5 years in the cases of ASC-US.

 Conclusions: It is necessary for all judged to require further examination to undergo detailed examination and adequate follow-up. This leads to saving the possibilities of fertility-preserving treatment for young examinees.