Postcoital bleeding is a predictor for cervical dysplasia
| Autor: | Gabby Chodick, Edwardo Schejter, Regina Agizim, Anat Hershko Klement, Omer Cohen, Ron Schonman, Ami Fishman |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Cervical polyp
Epidemiology Biopsy Uterine Cervical Neoplasms Cervicitis Cervical Cancer Pathology and Laboratory Medicine Vascular Medicine Uterine Cervical Diseases 0302 clinical medicine Risk Factors Medicine and Health Sciences 030212 general & internal medicine Israel Colposcopy Cervical cancer 030219 obstetrics & reproductive medicine Multidisciplinary medicine.diagnostic_test Obstetrics Cancer Risk Factors Incidence Incidence (epidemiology) Coitus Middle Aged Parity Oncology Medicine Female Research Article Papanicolaou Test Adult Dysplasia medicine.medical_specialty Adolescent Science Surgical and Invasive Medical Procedures Hemorrhage Carcinomas Young Adult 03 medical and health sciences Signs and Symptoms Abnormal PAP Smear Diagnostic Medicine Cancer Detection and Diagnosis medicine Humans Primary Care Retrospective Studies Vaginal Smears business.industry Cancers and Neoplasms Uterine Cervical Dysplasia medicine.disease Health Care Medical Risk Factors Case-Control Studies business Gynecological Tumors |
| Zdroj: | PLoS ONE, Vol 14, Iss 5, p e0217396 (2019) PLoS ONE |
| ISSN: | 1932-6203 |
| Popis: | Background Postcoital bleeding (PCB) is a common gynecological symptom that may cause concern among both patients and physicians. Current literature is inconclusive regarding management recommendations. Objective To identify risk-factors for dysplasia/cancer among patients presenting post-coital bleeding (PCB). Methods Using large health maintenance organization (HMO) database, all women reporting PCB in 2012–2015 were identified. PCB patient records in a single colposcopy center were reviewed. Age, marital status, ethnicity, gravidity, parity, BMI, smoking, PAP smear result (within 1 year of PCB presentation), colposcopy and biopsy results were recorded. Cases were matched by age and socio-economic enumeration area to controls accessing primary care clinics for routine care. Results Yearly incidence of PCB ranged from 400 to 900 per 100,000 women; highest among patients aged 26–30 years. Among the sample of 411 PCB cases with colposcopy, 201 (48.9%) had directed biopsy. Biopsy results included 68 cervicitis (33.8%), 61 koilocytosis/CIN 1/condyloma (30.3%), 44 normal tissue (21.9%), 25 cervical polyp (12.4%), 2 CIN 2/3 (1%) and 1 carcinoma (0.5%). Positive predictive value for koilocytosis/CIN 1 or higher pathology was 15.6% (64/411) and 0.7% for CIN 2 or higher grade pathology (3/411). In conditional logistic regression, multiparty was a protective factor: OR 0.39 (95% CI 0.22–0.88, P = 0.02), while pathological PAP smear was a related risk-factor: OR 3.3 (95% CI 1.31–8.35, P = 0.01). When compared to controls, PCB patients were significantly (P = 0.04) more likely to present CIN 1 or higher grade pathology (OR 1.82, 95% CI 1.02–3.33). Conclusions Study results indicate that PCB may require colposcopy, especially for nulliparous women with an abnormal PAP smear. |
| Databáze: | OpenAIRE |
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