Clinicopathologic analysis of patients with uterine-invasive cervical cancer often undergoing Pap screening

Abstract

Objective : We analyzed clinicopathological features of women with invasive cervical cancer (ICC) previously undergoing Papanicolaou (Pap) smears.
Study Design : Of 864 patients with cervical cancer seen from 1984 to 2006, we retrospectively analyzed cytopathological results and clinical findings in 70 who had undergone Pap tests within 3 years of treatment.
Results : Among 530 women diagnosed with ICC, 70 (13.2%) had Pap tests within 3 years before cancer was detected. Of the 70, 43 had squamous cell carcinoma (SCC) and 27 non-SCC. The rate of adenocarcinoma and early-stage ICC (stageIb orII) was statistically higher in those undergoing cancer screening. Of the 70, 56 (80%) had atypical bleeding and 40 (57%) visible cervical cancer. Of the 70, 21 had “abnormal” Pap test results and 49 (70%) “negative” cervical smear reports.
Conclusion : False-negative Pap test results occur in about 10% of tested populations and are frequently seen in patients with cervical adenocarcinoma. Liquid-based cytology (LBC) and human papillomavirus (HPV) testing are therefore recommended in cervical cancer screening, as is clinicophysical examination.