THE PRESENTATION OF ADENOCARCINOMA OF THE UTERINE CERVIX

Background. Among malignancies of the uterine cervix, the percentage o f adenocarcinomas seems to have increased in recent reports. Methods. The clinical presentation of adenocarcinoma of the uterine cervix duri ng the past 25 years was examined by review of charts and pathologic s pecimens. The data of a total of 124 patients with cervical adenocarci noma treated between 1964 and 1988 were evaluated. Results. During the 25-year period, the percentage of adenocarcinoma among all cervical m alignancies increased from 9% to 25%. In addition, the average number of new cases per year increased from 3.7 to 10.8. The percentage of wo men younger than 35 years with adenocarcinoma increased from 16% in 19 64 to 24% in 1989. Of these younger women, 74% had disease discovered by cytopathology, in comparison with 27% of the patients who were olde r than 35 years. The overall percentage of patients with disease diagn osed by cytology increased from 24% in the first half to 39% in the se cond half of the study period. Vaginal bleeding was the most common sy mptom. In the entire period, 57% of patients had International Federat ion of Gynecology and Obstetrics (FIGO) Stage I disease, with a median tumor diameter of 1 cm in patients with no symptoms and 3 cm in patie nts with symptoms. Outcome was inversely related to stage, tumor volum e, and the presence of lymph node metastasis but not to histologic tum or type. Conclusion. The frequency of adenocarcinoma of uterine cervix is increasing in patients 35 years or younger. Cytopathology is a goo d screening tool for these patients, leading to earlier diagnosis and improved outcome.