Cytology in the diagnosis of cervical cancer in symptomatic young women: a retrospective review

Anita Ww Lim; Rebecca Landy; Alejandra Castanon; Antony Hollingworth; Willie Hamilton; Nick Dudding; Peter Sasieni

doi:10.3399/bjgp16X687937

Cytology in the diagnosis of cervical cancer in symptomatic young women: a retrospective review

Anita Ww Lim, Rebecca Landy, Alejandra Castanon, Antony Hollingworth, Willie Hamilton, Nick Dudding, Peter Sasieni

Clinical Trials Unit Denmark Hill

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

Abstract

BACKGROUND: Cervical cancer in young women presents a diagnostic challenge because gynaecological symptoms are common but underlying disease is rare.

AIM: To explore the potential for using cytology as a diagnostic aid for cervical cancer in young women.

DESIGN AND SETTING: Retrospective review of primary care records and cytology data from the national cervical screening database and national audit of cervical cancers.

METHOD: Four datasets of women aged 20-29 years in England were examined: primary care records and national screening data from an in-depth study of cervical cancers; cytology from the national audit of cervical cancers; whole-population cytology from the national screening database; and general-population primary care records from the Clinical Practice Research Datalink. The authors explored the sensitivity and positive predictive value (PPV) of symptomatic cytology (earliest <12 months before diagnosis) to cervical cancer.

RESULTS: The estimated prevalence of cervical cancer among symptomatic women was between 0.4% and 0.9%. The sensitivity of moderate dyskaryosis (high-grade squamous intraepithelial lesion [HSIL]) or worse in women aged 20-29 years was 90.9% to 96.2% across datasets, regardless of symptom status. The PPV was estimated to be between 10.0% and 30.0%. For women aged 20-24 years, the PPV of '?invasive squamous carcinoma' was 25.4%, and 2.0% for severe or worse cytology.

CONCLUSION: Cytology has value beyond screening, and could be used as a diagnostic aid for earlier detection of cervical cancer in young women with gynaecological symptoms by ruling in urgent referral.

Original language	English
Pages (from-to)	e871-e879
Journal	The British journal of general practice : the journal of the Royal College of General Practitioners
Volume	66
Issue number	653
Early online date	24 Nov 2016
DOIs	https://doi.org/10.3399/bjgp16X687937
Publication status	Published - Dec 2016

Keywords

Adult
Cervical Intraepithelial Neoplasia
Cytological Techniques
Early Detection of Cancer
England
Female
Humans
Prevalence
Retrospective Studies
Sensitivity and Specificity
Uterine Cervical Neoplasms
Vaginal Smears
Young Adult
Journal Article
Validation Studies

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3399/bjgp16X687937Licence: CC BY

Cite this

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title = "Cytology in the diagnosis of cervical cancer in symptomatic young women: a retrospective review",

abstract = "BACKGROUND: Cervical cancer in young women presents a diagnostic challenge because gynaecological symptoms are common but underlying disease is rare.AIM: To explore the potential for using cytology as a diagnostic aid for cervical cancer in young women.DESIGN AND SETTING: Retrospective review of primary care records and cytology data from the national cervical screening database and national audit of cervical cancers.METHOD: Four datasets of women aged 20-29 years in England were examined: primary care records and national screening data from an in-depth study of cervical cancers; cytology from the national audit of cervical cancers; whole-population cytology from the national screening database; and general-population primary care records from the Clinical Practice Research Datalink. The authors explored the sensitivity and positive predictive value (PPV) of symptomatic cytology (earliest <12 months before diagnosis) to cervical cancer.RESULTS: The estimated prevalence of cervical cancer among symptomatic women was between 0.4% and 0.9%. The sensitivity of moderate dyskaryosis (high-grade squamous intraepithelial lesion [HSIL]) or worse in women aged 20-29 years was 90.9% to 96.2% across datasets, regardless of symptom status. The PPV was estimated to be between 10.0% and 30.0%. For women aged 20-24 years, the PPV of '?invasive squamous carcinoma' was 25.4%, and 2.0% for severe or worse cytology.CONCLUSION: Cytology has value beyond screening, and could be used as a diagnostic aid for earlier detection of cervical cancer in young women with gynaecological symptoms by ruling in urgent referral.",

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Cytology in the diagnosis of cervical cancer in symptomatic young women: a retrospective review. / Lim, Anita Ww; Landy, Rebecca; Castanon, Alejandra et al.
In: The British journal of general practice : the journal of the Royal College of General Practitioners, Vol. 66, No. 653, 12.2016, p. e871-e879.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Cytology in the diagnosis of cervical cancer in symptomatic young women

T2 - a retrospective review

AU - Lim, Anita Ww

AU - Landy, Rebecca

AU - Castanon, Alejandra

AU - Hollingworth, Antony

AU - Hamilton, Willie

AU - Dudding, Nick

AU - Sasieni, Peter

N1 - © British Journal of General Practice 2016.

PY - 2016/12

Y1 - 2016/12

N2 - BACKGROUND: Cervical cancer in young women presents a diagnostic challenge because gynaecological symptoms are common but underlying disease is rare.AIM: To explore the potential for using cytology as a diagnostic aid for cervical cancer in young women.DESIGN AND SETTING: Retrospective review of primary care records and cytology data from the national cervical screening database and national audit of cervical cancers.METHOD: Four datasets of women aged 20-29 years in England were examined: primary care records and national screening data from an in-depth study of cervical cancers; cytology from the national audit of cervical cancers; whole-population cytology from the national screening database; and general-population primary care records from the Clinical Practice Research Datalink. The authors explored the sensitivity and positive predictive value (PPV) of symptomatic cytology (earliest <12 months before diagnosis) to cervical cancer.RESULTS: The estimated prevalence of cervical cancer among symptomatic women was between 0.4% and 0.9%. The sensitivity of moderate dyskaryosis (high-grade squamous intraepithelial lesion [HSIL]) or worse in women aged 20-29 years was 90.9% to 96.2% across datasets, regardless of symptom status. The PPV was estimated to be between 10.0% and 30.0%. For women aged 20-24 years, the PPV of '?invasive squamous carcinoma' was 25.4%, and 2.0% for severe or worse cytology.CONCLUSION: Cytology has value beyond screening, and could be used as a diagnostic aid for earlier detection of cervical cancer in young women with gynaecological symptoms by ruling in urgent referral.

AB - BACKGROUND: Cervical cancer in young women presents a diagnostic challenge because gynaecological symptoms are common but underlying disease is rare.AIM: To explore the potential for using cytology as a diagnostic aid for cervical cancer in young women.DESIGN AND SETTING: Retrospective review of primary care records and cytology data from the national cervical screening database and national audit of cervical cancers.METHOD: Four datasets of women aged 20-29 years in England were examined: primary care records and national screening data from an in-depth study of cervical cancers; cytology from the national audit of cervical cancers; whole-population cytology from the national screening database; and general-population primary care records from the Clinical Practice Research Datalink. The authors explored the sensitivity and positive predictive value (PPV) of symptomatic cytology (earliest <12 months before diagnosis) to cervical cancer.RESULTS: The estimated prevalence of cervical cancer among symptomatic women was between 0.4% and 0.9%. The sensitivity of moderate dyskaryosis (high-grade squamous intraepithelial lesion [HSIL]) or worse in women aged 20-29 years was 90.9% to 96.2% across datasets, regardless of symptom status. The PPV was estimated to be between 10.0% and 30.0%. For women aged 20-24 years, the PPV of '?invasive squamous carcinoma' was 25.4%, and 2.0% for severe or worse cytology.CONCLUSION: Cytology has value beyond screening, and could be used as a diagnostic aid for earlier detection of cervical cancer in young women with gynaecological symptoms by ruling in urgent referral.

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KW - Cervical Intraepithelial Neoplasia

KW - Cytological Techniques

KW - Early Detection of Cancer

KW - England

KW - Female

KW - Humans

KW - Prevalence

KW - Retrospective Studies

KW - Sensitivity and Specificity

KW - Uterine Cervical Neoplasms

KW - Vaginal Smears

KW - Young Adult

KW - Journal Article

KW - Validation Studies

U2 - 10.3399/bjgp16X687937

DO - 10.3399/bjgp16X687937

M3 - Article

C2 - 27777232

SN - 0960-1643

VL - 66

SP - e871-e879

JO - The British journal of general practice : the journal of the Royal College of General Practitioners

JF - The British journal of general practice : the journal of the Royal College of General Practitioners

IS - 653

ER -

Cytology in the diagnosis of cervical cancer in symptomatic young women: a retrospective review

Abstract

Keywords

UN SDGs

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