Effect of cervical disease history on outcomes of women who have a pap diagnosis of atypical glandular cells of undetermined significance

Objective. To determine the relationship between history of cervical dyspla sia or carcinoma and the development of cervical dysplasia or adenocarcinom a in women who have a diagnosis of atypical glandular cells of undetermined significance (AGUS), favor endocervical origin, or AGUS, not otherwise spe cified. Methods. A 6-year retrospective review of the pathology files was performed for 93 women who were diagnosed in 1992 with AGUS, favor endocervical orig in, or AGUS, not otherwise specified. Data collected included previous hist ory of cervical disease, follow-up diagnoses, time interval between follow- ups, and procedures performed. Results. Of women with follow-up who had or did not have a previous history of cervical dysplasia, 32.0 and 12.0%, respectively, developed a squamous dysplasia or adenocarcinoma in situ. This difference was statistically sign ificant (P < 0.05). Of the women who had or did not have a previous history of cervical dysplasia and had Pap smear follow-up, only 4.2 and 4.3%, resp ectively, had a false-negative diagnosis on the most immediate subsequent s mear. Conclusions. Women who have AGUS, favor endocervical origin, or AGUS, not o therwise specified, and no history of cervical dysplasia have a significant ly lower risk of developing or having cervical dysplasia than women who hav e the same diagnosis and a history of cervical dysplasia. This may warrant different treatment protocols for these two groups. For the women with AGUS and no previous history of cervical dysplasia, a repeat Pap smear, rather than colposcopy with curettage, may be warranted. (C) 1999 Academic Press.