Effect of 2 referral intervals on diagnostic discordance between cytology and histology at a colposcopy clinic

Int J Gynaecol Obstet. 2013 Mar;120(3):257-61. doi: 10.1016/j.ijgo.2012.09.022. Epub 2013 Jan 23.

Abstract

Objective: To determine the effect of the time interval between cervical cytology screening and histology at treatment on grade of cervical disease.

Methods: In a retrospective cross-sectional study at a colposcopy clinic in Soweto, Johannesburg, South Africa, data were compared from women with cytologic abnormalities referred for colposcopy between April 2003 and June 2010 to determine whether early (≤ 180 days) or late (> 180 days) referral had an impact on dysplasia grade.

Results: In the early and late referral groups, there were 213 (13.43%) and 201 (14.63%) women, respectively, with upgrading of cervical dysplasia (P=0.35), and 1373 (86.57%) and 1173 (85.37%) women, respectively, with downgrading or no change (P=0.35). Risk factors for upgrading were HIV infection (odds ratio [OR], 1.63; P<0.001) and condom use (OR, 1.30; P=0.02). Four cases (0.68%) of invasion among women with low-grade squamous intraepithelial lesion (LSIL) and 50 cases (2.11%) among women with high-grade SIL (HSIL) were not detected by cytology. Risk factors for invasive disease on histology were age (OR, 1.09 per year; P<0.001), parity (OR, 1.32 per pregnancy; P<0.001), and HSIL on cytology (OR, 3.17; P=0.03).

Conclusion: There was no difference in the up- or downgrading of cervical dysplasia between the 2 referral groups.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Colposcopy / standards*
  • Cross-Sectional Studies
  • Female
  • HIV
  • HIV Infections / complications
  • HIV Infections / drug therapy
  • Humans
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Invasiveness
  • Parity
  • Pregnancy
  • Referral and Consultation / standards*
  • Retrospective Studies
  • Risk Factors
  • South Africa
  • Time Factors
  • Uterine Cervical Dysplasia / complications
  • Uterine Cervical Dysplasia / diagnosis*
  • Uterine Cervical Dysplasia / pathology
  • Uterine Cervical Neoplasms / complications
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / pathology
  • Young Adult