Skip to main content
Atencion Primaria logoLink to Atencion Primaria
. 2013 Apr 5;29(4):223–229. [Article in Spanish] doi: 10.1016/S0212-6567(02)70548-9

Anomalías citológicas de cérvix y lesiones precancerosas subsecuentes en un área sanitaria

Cell anomalies in the cervix and subsequent pre-cancerous lesions in a health area

Y Schmolling Guinovart a,*, JJ Barquín Solera a, A Zapata Ingelmo b, R Merino Segovia a, B Rodríguez Martínez a, E León González a
PMCID: PMC7684167  PMID: 11893298

Abstract

Objective

To determine the frequency of epithelial anomalies in cervical smears during the three years from August 1997 to July 2000 and of subsequent pre-cancerous lesions that are histologically confirmed, with differentiation also being made between health care levels.

Design

Retrospective descriptive study.

Setting

Anatomy Pathology referral Laboratory. Talavera de la Reina Health Area.

Participants

5,712 cervical smears and 70 biopsies.

Intervention

Review of path reports.

Main measurements and results

308 (5.4%) smears showed anomalies that were not attributed to a benign process. 209 (68%) of these were followed up, 139 (45%) of them through repetition of the smear and 70 (23%) through biopsy. Cell and cytology correlated in 42 women (30.2%), and cell-histology in 27 (38.6%) (0.47%, n = 5,712). 2,874 of the smears in the Area were taken in Primary Care, and 127 (22.2%) cell anomalies and 6 (0.1%) pre-cancerous lesions were found at this health care level.

Conclusions

The 5.4% frequency of anomalies is consistent with that in other population groups with an incidence of cervical cancer similar to ours. The 0.47% pre-cancerous lesions confirmed histologically is very low in comparison with the anomalies, which suggests that this intervention needs to be improved. This could be done by increasing biopsies for cell anomalies and screening of women at risk. Interpretation of smear reports, more information to the women and follow-up of the findings could all be improved, too.

Key words: Cervical smear, Screening, Histology, Cervical cancer, Pre-cancerous lesions

Bibliografía

  • 1.Screening for cervical cancer . Guide to clinical preventive services. 2nd ed. Williams and Wilkins; Baltimore: 1996. pp. 105–117. Report of the US Preventive Service Task Force. [Google Scholar]
  • 2.Vizcaíno A.P., Moreno V., Bosch F.X., Muñoz N., Barros-Dios X.M., Borrás J. International trends in incidence of cervical cancer: II. Squamous-cell carcinoma. Int J Cancer. 2000;86:429–435. doi: 10.1002/(sici)1097-0215(20000501)86:3<429::aid-ijc20>3.0.co;2-d. [DOI] [PubMed] [Google Scholar]
  • 3.Cervix uteri . In: Trends in cancer incidence and mortality. Coleman M.P., Estève J., Damiecki P., Arslan A., Renard H., editors. IARC Sci Publ n.o 121; Lyon: 1993. pp. 433–454. [DOI] [PubMed] [Google Scholar]
  • 4.Kurman R.J., Solomon D. The Bethesda system for reporting cervical/vaginal cytologic diagnoses. Springer-Verlag; New York: 1994. [Google Scholar]
  • 5.Bosch F.X., Manos M.M., Muñoz N., Sherman M., Jansen A.M., Peto J. Prevalence of human papillomavirus in cervical cancer: a worlwide perspective. International Biological Study on Cervical Cancer (IBSCC) Study Group. J Natl Cancer Inst. 1995;87:796–802. doi: 10.1093/jnci/87.11.796. [DOI] [PubMed] [Google Scholar]
  • 6.Fahey M.T., Irwig L., Macaskill P. Meta-analysis of Pap test accuracy. Am J Epidemiol. 1995;141:680–689. doi: 10.1093/oxfordjournals.aje.a117485. [DOI] [PubMed] [Google Scholar]
  • 7.Parkin D.M., Whelan S.L., Ferlay J., Raymond L., Young L. Cancer incidence in five continents. IARC Sci Publ n.o 143; Lyon: 1997. [Google Scholar]
  • 8.Mortalidad por cáncer en España 1997. Servicio de Epidemiología del Cáncer. Centro Nacional de Epidemiología http://193.146.50.130/cancer/mort97.txt
  • 9.Alonso Gordo J.M., Bellas Beceiro B., Cierco Peguera P., Gálvez Ibáñez M., González Enríquez J., Martín Blanco N. Prevención del cáncer. Aten Primaria. 1999;24(Supl 1):76–98. [PubMed] [Google Scholar]
  • 10.González J., Villar F. Detección precoz del cáncer de cérvix uterino. ¿Es una prioridad en España? Aten Primaria. 1993;12:570–572. [PubMed] [Google Scholar]
  • 11.Spagnolo de la Torre E., Segura Benedicto A., Vila Macau R., Andrés Martínez J., Sans Menéndez S. Importancia del cáncer de cérvix en Cataluña. Consideraciones sobre un eventual programa de cribaje. Med Clin (Barc) 1984;82:83–86. [PubMed] [Google Scholar]
  • 12.Grupo de Trabajo de Detección Precoz de Cáncer de Mama y Cáncer de Cérvix Uterino Criterios generales y recomendaciones para la elaboración de programas de detección de cáncer de mama y cáncer de cérvix uterino en España. Rev San Hig Pub. 1993;67:23–37. [PubMed] [Google Scholar]
  • 13.Walsh J.M. Cervical cancer: developments in screening and evaluation of the abnormal Pap smear. West J Med. 1998;169:304–310. [PMC free article] [PubMed] [Google Scholar]
  • 14.Consejería de Sanidad y Bienestar Social . Tres años del Programa de Prevención de Cánceres e Infecciones Ginecológicas, 1991–1993. Junta de Castilla y León; Valladolid: 1994. [Google Scholar]
  • 15.Raffle A.E., Alden B., Mckenzie E.F. Tasas de detección de citologías cervicales patológicas ¿qué estamos buscando? Lancet (ed. esp) 1995;27:242–247. [Google Scholar]
  • 16.Chhieng D.C., Elgert P.A., Cangiarella J.F., Cohen J.M. Clinical significance of atypical glandular cells of undetermined significance. Acta Cytol. 2000;44:557–566. doi: 10.1159/000328530. [DOI] [PubMed] [Google Scholar]
  • 17.Soost H.J., Lange H.J., Lehmacher W., Rufling-Kullman B. The validation of cervical cytology. Acta Cytol. 1991;35:8–14. [PubMed] [Google Scholar]
  • 18.Davey D.D., Woodhouse S., Styer P., Stastry J., Mody D.L. Atypical epithelial cells and specimen adequacy: current laboratory practices of participants in the College of American Pathologists interlabortory comparison in cervicovaginal cytology. Arch Pathol Lab Med. 2000;124:203–211. doi: 10.5858/2000-124-0203-AECASA. [DOI] [PubMed] [Google Scholar]
  • 19.Surís J.C., Dexeus S., López–Marín L. Epidemiology of preinvasive lesions. Eur J Gynaecol Oncol. 1999;20:302–305. [PubMed] [Google Scholar]
  • 20.Solomon D., Frable W.J., Wooijs G.P., Wilbur D.C., Amma N.S., Collins R.J. ASCUS and AGUS criteria: IAC Task Force Summary. Acta Cytol. 1998;42:15–23. doi: 10.1159/000331531. [DOI] [PubMed] [Google Scholar]
  • 21.Meijers C.J.L.M., Helmerhorst ThJM. Rozendaal L., Van der Linden J.C., Voorhorst F.J., Walboomers J.M.M. HPV typing testing in gynecological pathology: has the time come? Histopathology. 1998;33:83–86. doi: 10.1046/j.1365-2559.1998.00436.x. [DOI] [PubMed] [Google Scholar]
  • 22.Muñoz N., Bosh F.X. Cervical cancer and human papilomavirus: epidemiological evidence and perspectives for prevention. Salud Publica Mex. 1997;39:274–282. doi: 10.1590/s0036-36341997000400005. [DOI] [PubMed] [Google Scholar]
  • 23.Parazzini F., Chatenoud L., La Vecchia C., Chiaffarino F., Ricci E., Negri E. Time since last use of oral contraceptives and risk of invasive cervical cancer. Eur J Cancer. 1998;34:357–365. doi: 10.1016/s0959-8049(97)10139-3. [DOI] [PubMed] [Google Scholar]
  • 24.Becker T., Wheeler C., McGough N., Stidley C., Parmenter C., Dorin M. Contraceptive and reproductive risks for cervical dysplasia in southwestern hispanic and non-hispanic white women. Int J Epidemiology. 1994;23:913–922. doi: 10.1093/ije/23.5.913. [DOI] [PubMed] [Google Scholar]
  • 25.IARC Working group on evaluation of cervical cancer screening programmes Screening for squamous cervical cancer: duration of low risk after negative results of cervical cytology and its implication for screening policies. BMJ. 1986;293:659–664. doi: 10.1136/bmj.293.6548.659. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 26.Gálvez Ibáñez M., González Enríquez J., Lubián López M. Cribado de cáncer de cérvix. A quién y cuándo. Aten Primaria. 1998;21:234–239. [PubMed] [Google Scholar]
  • 27.Olazábal J.C., Montero J., Pastor F., Alario M.J., García R., García J.F. Diez años de citologías de cérvix uterino en un centro de salud. Aten Primaria. 1997;20:293–298. [PubMed] [Google Scholar]
  • 28.Valero F., Nebot M.J., Fenollosa B., Covira A., Rius J. Correlación entre el diagnóstico colposcópico y citohistológico en 285 casos de CIN. Prog Obstet Ginecol. 1989;32:40–42. [Google Scholar]
  • 29.Gimeno Ortiz A., Jiménez Romano R., Camps Pérez del Bosque J.R. Cáncer de cuello uterino en Extremadura. Rev San Hig Pub. 1993;67:217–225. [PubMed] [Google Scholar]
  • 30.Borrego J.A., Santaella M., Márquez A.J., Martínez Cabral C., Arjona J.E. Incidencia de patología cervical inflamatoria y preneoplásica en una consulta de ETS. Prog Obstet Gineco. 1988;31:635–639. [Google Scholar]
  • 31.Mody Dr. Davey D.D., Branca M., Raab S.S., Schenck U.G., Stanley M.W. Quality assurance and risk reduction guidelines. Acta Cytol. 2000;44:496–507. doi: 10.1159/000328521. [DOI] [PubMed] [Google Scholar]

Articles from Atencion Primaria are provided here courtesy of Elsevier

RESOURCES