Follow‐up and clinical significance of unsatisfactory liquid‐based Papanicolaou tests. Issue 1 (23rd October 2014)

• Record Type: Journal Article
• Authors: Owens, Christopher L.; Buist, Diana S.M.; Peterson, Daniel; Kamineni, Aruna; Weinmann, Sheila; Ross, Tyler; Williams, Andrew E.; Stark, Azadeh; Adams, Kenneth F.; Doubeni, Chyke A.; Field, Terry S.
• Is Part Of: Cancer cytopathology. Volume 123:Issue 1(2015:Jan.)
• Page Start: 59
• Page End: 65
• Publication Date: 2014-10-23
• Subjects: Cancer -- Cytopathology -- Periodicals; Pathology, Cellular -- Periodicals; Cytology -- Technique -- Periodicals; 611.01815
• DOI: 10.1002/cncy.21490
• Languages: English
• ISSNs: 1934-662X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="cncy21490-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>To the authors' knowledge, few studies to date have examined adherence to recommended guidelines for follow‐up and outcomes after an unsatisfactory Papanicolaou (Pap) test (UPT) with liquid‐based technologies.</p> </sec> <sec id="cncy21490-sec-0002" sec-type="section"> <title>METHODS</title> <p>Within 4 US health plans, the median time to follow‐up and the percentage of patients with follow‐up testing by 120 days was calculated after a UPT. Multivariable analyses evaluated the association between clinical factors and follow‐up testing. The authors compared the risk of a diagnosis of cervical intraepithelial neoplasia of type 2 or worse (CIN2+) after a UPT with the risk after a satisfactory Pap test while controlling for study site, test year, and other covariates.</p> </sec> <sec id="cncy21490-sec-0003" sec-type="section"> <title>RESULTS</title> <p>A total of 634, 644 Pap tests performed between 2004 and 2010 were included in the current study. Of 1442 UPTs, 53.4% had follow‐up testing within 120 days; follow‐up differed across the health plans (<italic>P</italic><.001) and was found to be higher among patients aged <50 years (57.2% vs 48.8%; <italic>P</italic> = .01) and those with positive human papillomavirus (HPV) results (84.6% vs 53.9; <italic>P</italic> <.01). The risk of CIN2+ was similar for patients with both unsatisfactory and satisfactory Pap tests. However, after a UPT, the variables of age <50 years, having no previous history of Pap testing, having a history of a previous abnormal Pap test, and positive HPV status were all found to be risk factors for CIN2+; a positive HPV test was found to be the strongest risk factor for developing CIN2+. A negative HPV test result was protective for a CIN2+ diagnosis.</p> </sec> <sec id="cncy21490-sec-0004" sec-type="section"> <title>CONCLUSIONS</title> <p>Various clinical factors associated with the risk of CIN2+ appear to influence the receipt of follow‐up after a UPT. HPV test results in patients with UPTs might be used in follow‐up strategies; specifically, a negative test result might reduce the urgency for repeat Pap testing. <bold><italic>Cancer (Cancer Cytopathol)</italic> 2015;123:59–65</bold>. © <italic>2014 American Cancer Society</italic>.</p> </sec> </abstract>