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. 1994 Apr;86(4):273–277.

Significance of a first-time atypical Papanicolaou smear in a young, high-risk African-American and Latino-American population.

G P Parham 1, M Shaver 1, P Brown 1, T Zumwalt 1, F Salem 1, E W Savage 1
PMCID: PMC2607629  PMID: 7794301

Abstract

The first atypical Papanicolaou smear in young, sexually active Latino and African-American women of low socioeconomic status may be predictive of underlying cervical neoplasia and human papillomavirus infection of significant quantity. The optimal management of first-time atypia on routine Pap smear has not been established. In many clinics, colposcopically directed sampling of the cervix is recommended only if atypia persists following specific or nonspecific treatment of cervicitis or after an arbitrarily determined time interval. Others recommend immediate colposcopic evaluation. To determine the best approach to the first-time atypical Pap smear in young minority women at high risk for the development of cervical cancer, 250 such patients were evaluated with colposcopically directed biopsy of the cervix prior to any form of therapy. Pap smears were repeated at the time of colposcopy. Histologically, there was evidence of cervical intraepithelial neoplasia in 41% of patients and human papillomavirus infection in 86%. Repeat Pap smears predicted the presence of cervical intraepithelial neoplasia in only 24% of patients. Immediate colposcopic evaluation represents the most prudent approach to the first-time atypical Pap smear in young, high-risk minority women.

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Selected References

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

  1. Busseniers A. E., Sidawy M. K. Inflammatory atypia on cervical smears. A diagnostic dilemma for the gynecologist. J Reprod Med. 1991 Feb;36(2):85–88. [PubMed] [Google Scholar]
  2. Davis G. L., Hernandez E., Davis J. L., Miyazawa K. Atypical squamous cells in Papanicolaou smears. Obstet Gynecol. 1987 Jan;69(1):43–46. [PubMed] [Google Scholar]
  3. Della Torre G., Pilotti S., de Palo G., Rilke F. Viral particles in cervical condylomatous lesions. Tumori. 1978 Oct 31;64(5):549–553. doi: 10.1177/030089167806400513. [DOI] [PubMed] [Google Scholar]
  4. Hammond E. C., Burns E. L., Seidman H., Percy C. Detection of uterine cancer. High and low risk groups. Cancer. 1968 Dec;22(6):1096–1107. doi: 10.1002/1097-0142(196811)22:6<1096::aid-cncr2820220604>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  5. Hulka B. S. Cytologic and histologic outcome following an atypical cervical smear. Am J Obstet Gynecol. 1968 May 15;101(2):190–199. doi: 10.1016/0002-9378(68)90187-7. [DOI] [PubMed] [Google Scholar]
  6. Jones D. E., Creasman W. T., Dombroski R. A., Lentz S. S., Waeltz J. L. Evaluation of the atypical Pap smear. Am J Obstet Gynecol. 1987 Sep;157(3):544–549. doi: 10.1016/s0002-9378(87)80004-2. [DOI] [PubMed] [Google Scholar]
  7. KOSS L. G., DURFEE G. R. Unusual patterns of squamous epithelium of the uterine cervix: cytologic and pathologic study of koilocytotic atypia. Ann N Y Acad Sci. 1956 Mar 30;63(6):1245–1261. doi: 10.1111/j.1749-6632.1956.tb32134.x. [DOI] [PubMed] [Google Scholar]
  8. Kohan S., Noumoff J., Beckman E. M., Morris M., Weiner E., Douglas G. W. Colposcopic screening of women with atypical Papanicolaou smears. J Reprod Med. 1985 May;30(5):383–387. [PubMed] [Google Scholar]
  9. Maier R. C., Schultenover S. J. Evaluation of the atypical squamous cell Papanicolaou smear. Int J Gynecol Pathol. 1986;5(3):242–248. doi: 10.1097/00004347-198609000-00006. [DOI] [PubMed] [Google Scholar]
  10. Makuc D. M., Freid V. M., Kleinman J. C. National trends in the use of preventive health care by women. Am J Public Health. 1989 Jan;79(1):21–26. doi: 10.2105/ajph.79.1.21. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Meisels A., Fortin R., Roy M. Condylomatous lesions of the cervix. II. Cytologic, colposcopic and histopathologic study. Acta Cytol. 1977 May-Jun;21(3):379–390. [PubMed] [Google Scholar]
  12. Nelson J. H., Jr, Hall J. E. Detection, diagnostic evaluation, and treatment of dysplasia and early carcinoma of the cervix. CA Cancer J Clin. 1970 May-Jun;20(3):150–163. doi: 10.3322/canjclin.20.3.150. [DOI] [PubMed] [Google Scholar]
  13. Noumoff J. S. Atypia in cervical cytology as a risk factor for intraepithelial neoplasia. Am J Obstet Gynecol. 1987 Mar;156(3):628–631. doi: 10.1016/0002-9378(87)90065-2. [DOI] [PubMed] [Google Scholar]
  14. Nyirjesy I. Atypical or suspicious cervical smears. An aggressive diagnostic approach. JAMA. 1972 Nov 6;222(6):691–693. [PubMed] [Google Scholar]
  15. Purola E., Savia E. Cytology of gynecologic condyloma acuminatum. Acta Cytol. 1977 Jan-Feb;21(1):26–31. [PubMed] [Google Scholar]
  16. Reid R., Laverty C. R., Coppleson M., Isarangkul W., Hills E. Noncondylomatous cervical wart virus infection. Obstet Gynecol. 1980 Apr;55(4):476–483. [PubMed] [Google Scholar]
  17. Reiter R. C. Management of initial atypical cervical cytology: a randomized, prospective study. Obstet Gynecol. 1986 Aug;68(2):237–240. [PubMed] [Google Scholar]
  18. Sandmire H. F., Austin S. D., Bechtel R. C. Experience with 40,000 Papanicolaou smears. Obstet Gynecol. 1976 Jul;48(1):56–60. [PubMed] [Google Scholar]
  19. Syrjänen K. J. Condylomatous lesions in dysplastic and neoplastic epithelium of the uterine cervix. Surg Gynecol Obstet. 1980 Mar;150(3):372–376. [PubMed] [Google Scholar]
  20. Syrjänen K. J. Current views on the condylomatous lesions in uterine cervix and their possible relationship to cervical squamous cell carcinoma. Obstet Gynecol Surv. 1980 Nov;35(11):685–694. [PubMed] [Google Scholar]
  21. Syrjänen K. J. Morphologic survey of the condylomatous lesions in dysplastic and neoplastic epithelium of the uterine cervix. Arch Gynecol. 1979 Aug;227(2):153–161. doi: 10.1007/BF02103290. [DOI] [PubMed] [Google Scholar]

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