B. Bertelsen et F. Hartveit, THE CERVICAL SMEAR RECORD - ITS RELEVANCE TO THE SUBSEQUENT DEVELOPMENT OF CERVICAL NEOPLASIA, Acta obstetricia et gynecologica Scandinavica, 74(9), 1995, pp. 729-733
Background. Our aim was to investigate the previous smear history in w
omen with cervical intraepithelial neoplasia grade 1-3 or squamous car
cinoma and define its relevance to the lesion present in 1989. Methods
. All 850 women with a laboratory record of cervical intraepithelial n
eoplasia or cervical squamous carcinoma in 1989 were studied. We retri
eved their cytological and histological cervical diagnoses for the per
iod 1981 to 1992 from the laboratory files. On this basis we assessed
their previous smear history and short term clinical outcome. Results.
Half the women had a negative record prior to 1989, irrespective of t
he grade of their lesion in that year. Cervical intraepithelial neopla
sia grade I had previously been found in 16%, grade 2 in 10%, and grad
e 3 in 7%. These levels were not related to the grade present in '89,
but as in those with a negative record, were proportional to the numbe
r of women examined, and thus reflect the frequency of such lesions in
the screened population in general. In all, 310 were treated operativ
ely for cervical intraepithelial neoplasia grade 3 following abnormal
findings in 1989. In such cases abnormal findings were also common in
'88, although 45% of them still had a negative smear history. The grou
p with no previous record, i.e. unscreened, contained significantly mo
re invasive cases. Conclusions. In women with cervical intraepithelial
neoplasia in 1989, their previous smear history did not indicate the
grade of lesion present. The relevance of their previous abnormal slid
es to that lesion is thus questionable. The findings, however, suggest
that progressive lesions may be acute in origin, superimposed in some
cases on a history of similar morphological abnormalities.