BACKGROUND:

The National Health and Medical Research Council of Australia Guidelines for the Management of Women with Screen Detected Abnormalities are under review. The availability of population-based Australian data on the outcome after a cytology prediction of glandular abnormality was considered relevant to revising the recommended investigations for women with these abnormalities.

AIM:

To describe the outcome of women with cytological predictions of glandular abnormalities of the cervix during 1999.

METHODS:

A longitudinal study using data held by the Pap Test Registers of Australia.

RESULTS:

Over a 24 month period, 70% (95% confidence interval (CI) 62-78%) of women whose cytology was reported as adenocarcinoma in situ (AIS) were confirmed as having high-grade disease. Among women whose cytology was reported as 'inconclusive: possible high-grade glandular disease', the proportion of women having high-grade disease was 25% (95% CI 20-30%). For cytology reports of minor non-specific change (MNSC) of glandular cells, the proportion of women having high-grade disease was 10% (95% CI 8-12%). Cancer was diagnosed in 16%, 5% and <1% of women with index cytology reports of AIS, inconclusive and MNSC, respectively.

CONCLUSIONS:

These results can be used to inform an evidence-based approach to the investigation and management of abnormal glandular cytology reports. The results can also be used to better inform women about the significance of their abnormal cytology.