Skip to main content
NCBI home page
Genitourinary Medicine logoLink to Genitourinary Medicine
. 1997 Oct;73(5):383–386. doi: 10.1136/sti.73.5.383

Effect of concurrent lower genital tract infections on cervical cancer screening.

J R Schwebke 1, M E Zajackowski 1
PMCID: PMC1195897  PMID: 9534749

Abstract

BACKGROUND AND OBJECTIVES: Although women attending STD clinics are at high risk for cervical cancer, most STD programmes do not include Papanicolaou (Pap) smears in their routine screening procedures. Concerns regarding reliability of this test in a population with a high rate of active infection are often raised. The objective of this study was to analyse the associations between STD diagnosis/clinical syndromes and unsatisfactory and abnormal Pap smears. METHODS: Retrospective analysis of Pap results and medical records from women attending an inner city STD programme. RESULTS: Of the 1202 patients analysed, 3.2% had squamous intraepithelial lesions (SIL) and 3.5% had smears which were unsatisfactory because of the thickness of the specimen. There were no associations between STD diagnoses and SIL; however, the presence of cervical inflammation was significantly associated with SIL. Pap smears which were unsatisfactory because they were too thick were also associated with the clinical finding of cervical inflammation. CONCLUSIONS: The presence of active infection did not preclude the detection of SIL on Pap smears. The percentage of unsatisfactory smears resulting from inflammation was low.

Full text

PDF
383

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amsel R., Totten P. A., Spiegel C. A., Chen K. C., Eschenbach D., Holmes K. K. Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med. 1983 Jan;74(1):14–22. doi: 10.1016/0002-9343(83)91112-9. [DOI] [PubMed] [Google Scholar]
  2. Boring C. C., Squires T. S., Tong T., Montgomery S. Cancer statistics, 1994. CA Cancer J Clin. 1994 Jan-Feb;44(1):7–26. doi: 10.3322/canjclin.44.1.7. [DOI] [PubMed] [Google Scholar]
  3. Briggs R. M., Holmes K. K., Kiviat N., Barker E., Eschenbach D. A., DeJong R. High prevalence of cervical dysplasia in STD clinic patients warrants routine cytologic screening. Am J Public Health. 1980 Nov;70(11):1212–1214. doi: 10.2105/ajph.70.11.1212. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Brunham R. C., Paavonen J., Stevens C. E., Kiviat N., Kuo C. C., Critchlow C. W., Holmes K. K. Mucopurulent cervicitis--the ignored counterpart in women of urethritis in men. N Engl J Med. 1984 Jul 5;311(1):1–6. doi: 10.1056/NEJM198407053110101. [DOI] [PubMed] [Google Scholar]
  5. Cramer D. W. The role of cervical cytology in the declining morbidity and mortality of cervical cancer. Cancer. 1974 Dec;34(6):2018–2027. doi: 10.1002/1097-0142(197412)34:6<2018::aid-cncr2820340621>3.0.co;2-b. [DOI] [PubMed] [Google Scholar]
  6. Eckert L. O., Koutsky L. A., Kiviat N. B., Krone M. R., Stevens C. E., Eschenbach D. A. The inflammatory Papanicolaou smear: what does it mean? Obstet Gynecol. 1995 Sep;86(3):360–366. doi: 10.1016/0029-7844(95)00196-X. [DOI] [PubMed] [Google Scholar]
  7. Fruchter R. G., Boyce J., Hunt M. Missed opportunities for early diagnosis of cancer of the cervix. Am J Public Health. 1980 Apr;70(4):418–420. doi: 10.2105/ajph.70.4.418. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Janerich D. T., Hadjimichael O., Schwartz P. E., Lowell D. M., Meigs J. W., Merino M. J., Flannery J. T., Polednak A. P. The screening histories of women with invasive cervical cancer, Connecticut. Am J Public Health. 1995 Jun;85(6):791–794. doi: 10.2105/ajph.85.6.791. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Kamb M. L. Cervical cancer screening of women attending sexually transmitted disease clinics. Clin Infect Dis. 1995 Apr;20 (Suppl 1):S98–103. doi: 10.1093/clinids/20.supplement_1.s98. [DOI] [PubMed] [Google Scholar]
  10. Kinlay S., Heller R. F. Selective screening for high cholesterol in Australian general practice: the Newcastle Cholesterol Prediction Study. J Gen Intern Med. 1990 Jan-Feb;5(1):1–8. doi: 10.1007/BF02602300. [DOI] [PubMed] [Google Scholar]
  11. Koutsky L. A., Galloway D. A., Holmes K. K. Epidemiology of genital human papillomavirus infection. Epidemiol Rev. 1988;10:122–163. doi: 10.1093/oxfordjournals.epirev.a036020. [DOI] [PubMed] [Google Scholar]
  12. Koutsky L. A., Holmes K. K., Critchlow C. W., Stevens C. E., Paavonen J., Beckmann A. M., DeRouen T. A., Galloway D. A., Vernon D., Kiviat N. B. A cohort study of the risk of cervical intraepithelial neoplasia grade 2 or 3 in relation to papillomavirus infection. N Engl J Med. 1992 Oct 29;327(18):1272–1278. doi: 10.1056/NEJM199210293271804. [DOI] [PubMed] [Google Scholar]
  13. Lawley T. B., Lee R. B., Kapela R. The significance of moderate and severe inflammation on class I Papanicolaou smear. Obstet Gynecol. 1990 Dec;76(6):997–999. [PubMed] [Google Scholar]
  14. Marcus A. C., Crane L. A., Kaplan C. P., Goodman K. J., Savage E., Gunning J. Screening for cervical cancer in emergency centers and sexually transmitted disease clinics. Obstet Gynecol. 1990 Mar;75(3 Pt 1):453–455. [PubMed] [Google Scholar]
  15. Michielutte R., Dignan M. B., Wells H. B., Bahnson J., Smith M., Wooten R., Hale L. N. Errors in reporting cervical screening among public health clinic patients. J Clin Epidemiol. 1991;44(4-5):403–408. doi: 10.1016/0895-4356(91)90078-n. [DOI] [PubMed] [Google Scholar]
  16. Reeves W. C., Rawls W. E., Brinton L. A. Epidemiology of genital papillomaviruses and cervical cancer. Rev Infect Dis. 1989 May-Jun;11(3):426–439. doi: 10.1093/clinids/11.3.426. [DOI] [PubMed] [Google Scholar]
  17. Smeltzer M. P., Curran J. W., Brown S. T., Pass J. Accuracy of presumptive criteria for culture diagnosis of Neisseria gonorrhoeae in low-prevalence populations of women. J Clin Microbiol. 1980 May;11(5):485–487. doi: 10.1128/jcm.11.5.485-487.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Genitourinary Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES