Age-related changes in the diagnostic assessment of women with severe cervical lesions. (August 2015)

• Record Type: Journal Article
• Authors: Giannella, L.; Fodero, C.; Boselli, F.; Mfuta, K.; Rubino, T.; Prandi, S.
• Is Part Of: Climacteric. Volume 18:Number 4(2015:Aug.)
• Page Start: 617
• Page End: 623
• Publication Date: 2015-08
• Subjects: Menopause -- Periodicals; Menopause -- Hormone therapy -- Periodicals; Menopause -- Periodicals; Estrogen Replacement Therapy -- Periodicals; Gynecology -- Periodicals; Societies, Medical -- Periodicals; 612.665
• DOI: 10.3109/13697137.2015.1005592
• Languages: English
• ISSNs: 1369-7137

Abstract

<abstract> <title>Abstract</title> <p> <italic>Objectives</italic> To evaluate the effect of age on the diagnostic assessment of women with severe cervical intraepithelial neoplasia (CIN).</p> <p> <italic>Methods</italic> This retrospective observational study included 338 consecutive women with a diagnosis of CIN3 on cone specimen. Patients were divided into three groups according to age: < 35 years (Group A), 35–49 years (Group B), and ≥ 50 years (Group C). Clinical and colposcopic variables were compared, and human papillomavirus (HPV) genotype distribution was measured.</p> <p> <italic>Results</italic> The most common HPV genotype was HPV-16 (63.65%), followed by HPV-33 (7%), HPV-18 (6.2%), and HPV-31 (5.4%). The rate of the following high-grade lesion predictors was lower in Group C than in Groups A and B: HPV-16 infections (55.9% vs. 75% vs. 70.9%, respectively, <italic>p</italic> = 0.022); high-grade colposcopic impression (29.4% vs. 51.8% vs. 51.7%, respectively, <italic>p</italic> < 0.0001); and high-grade cytological changes (30.9% vs. 56.2% vs. 45.4%, respectively, <italic>p</italic> = 0.025). An endocervical lesion location was more frequent in Group C than in Groups A and B (55.6% vs. 6.8% vs. 11.8%, respectively, <italic>p</italic> < 0.0001).</p> <p> <italic>Conclusion</italic> Women aged 50 years and older with CIN3 showed a significant reduction of high-grade lesion predictors along with physiological confounding cervical changes (transformation zone type 3 and endocervical lesion location). The diagnostic work-up of cervical lesions in older women should provide their potential consideration as a special population.</p> </abstract>