THE INCIDENCE OF CERVICAL INTRAEPITHELIAL NEOPLASIA AMONG WOMEN WITH RENAL-TRANSPLANT IN RELATION TO CYCLOSPORINE

Objective To evaluate the policy of an annual smear to screen renal tr ansplant recipients for cervical intraepithelial neoplasia and invasiv e carcinoma and to determine the incidence of abnormal smears and CIN before and after the introduction of cyclosporine (1983). Design A ret rospective study over the period 1971 to 1992. Subjects Postmenarchial women who received renal transplants and who suppressive treatment fo r at least one month. Mean outcome measures Cytology and histology res ults. Results A total of 144 women who received renal transplantation were eligible for our study. Observation time varied from 1 to 227 mon ths (median 59 months) with a mean for the group transplanted before 1 983 (Group A) of 103 months, and for the group transplanted after 1983 (Group B) of 46 months. Of these women, 25 had an abnormal smear. Of these, 14 were confirmed by histology and repeated smears of the other 11 patients were negative. Within the 60 women in Group A.with an abn ormal smear, six had CIN I or CIN II, three had CIN III and one showed adenocarcinoma of the endometrium. Among the 84 women in Group B, fou r had CIN I or CIN II and none had CIN III. The overall incidence of a bnormal cytology was 17.3%, with no invasive cervical carcinoma in thi s group. Conclusions Our policy of screening is adequate. With the int roduction of cyclosporine the incidence of abnormal cytology and histo logy has a tendency to decrease. However, the duration of risk is not comparable yet.