Title |
Cytology in the diagnosis of cervical cancer in symptomatic young women: a retrospective review
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Published in |
British Journal of General Practice, October 2016
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DOI | 10.3399/bjgp16x687937 |
Pubmed ID | |
Authors |
Anita WW Lim, Rebecca Landy, Alejandra Castanon, Antony Hollingworth, Willie Hamilton, Nick Dudding, Peter Sasieni |
Abstract |
Cervical cancer in young women presents a diagnostic challenge because gynaecological symptoms are common but underlying disease is rare. To explore the potential for using cytology as a diagnostic aid for cervical cancer in young women. Retrospective review of primary care records and cytology data from the national cervical screening database and national audit of cervical cancers. 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. 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. 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. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 12 | 48% |
India | 2 | 8% |
Canada | 1 | 4% |
Ireland | 1 | 4% |
Comoros | 1 | 4% |
Unknown | 8 | 32% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 14 | 56% |
Scientists | 7 | 28% |
Practitioners (doctors, other healthcare professionals) | 3 | 12% |
Science communicators (journalists, bloggers, editors) | 1 | 4% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 57 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 11 | 19% |
Student > Ph. D. Student | 11 | 19% |
Student > Bachelor | 10 | 18% |
Student > Master | 6 | 11% |
Other | 5 | 9% |
Other | 5 | 9% |
Unknown | 9 | 16% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 27 | 47% |
Biochemistry, Genetics and Molecular Biology | 4 | 7% |
Pharmacology, Toxicology and Pharmaceutical Science | 4 | 7% |
Nursing and Health Professions | 3 | 5% |
Computer Science | 2 | 4% |
Other | 6 | 11% |
Unknown | 11 | 19% |