Management of Atypical Squamous Cell Cases: A Prospective Study of Women seen at a Private Health Service in Northeastern Brazil

Detalhes bibliográficos
Autor(a) principal: Oliveira,Geilson Gomes de
Data de Publicação: 2018
Outros Autores: Oliveira,Judite Maria da Silva Costa de, Eleutério,Renata Mirian Nunes, Eleutério Júnior,José
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista brasileira de ginecologia e obstetrícia (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032018000300121
Resumo: Abstract Objective To assess the management chosen by gynecologists after atypical squamous cells (ASCs) cytology results, and to evaluate the outcomes of these cases in Brazilian women. Methods A prospective observational study evaluated the initial management offered by the gynecologist in the case of 2,458 ASCs cytology results collected between January of 2010 and July of 2016. The outcomes of the cytology, high-risk human papilloma virus (HR-HPV) test and histology were compared in two subgroups: atypical squamous cells of undetermined significance (ASC-US) and atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H). Results In many cases of ASC-US (36.97%) and ASC-H (40.50%), no clinical actions were taken. Cytology was the most frequent follow-up chosen, including for cases of ASC-H, which goes against the conduct recommended in the national guideline. In women over 30 years of age, the period of time elapsed between an ASC-US result and a new cytology was in 13.03 months, in disagreement with the national guideline recommendations (p< 0.0001). Negative for intraepithelial lesions or malignancy (NILM) cytologic (p = 0.0026) and histologic (p = 0.0017) results in the follow-up were associated with prior ASC-US, while negative results for ASC-H were cytologically (p< 0.0001) and histologically associated with high-grade squamous intraepithelial lesion (HSIL) (p< 0.0001). Two invasive cervical carcinomas (ICCs) were found in the follow-up for ASC-H, and there was a statistically significant association (p = 0.0341). A positive HR-HPV test was associated with ASC-H (p = 0.0075). Conclusion The data suggest that even for a population of Brazilian women assisted at private clinics, the national guidelines recommendations for ASCs results are not followed.
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spelling Management of Atypical Squamous Cell Cases: A Prospective Study of Women seen at a Private Health Service in Northeastern Braziluterine cervical neoplasmdisease managementatypical squamous cells of the cervixpapanicolaou testhuman papillomavirusAbstract Objective To assess the management chosen by gynecologists after atypical squamous cells (ASCs) cytology results, and to evaluate the outcomes of these cases in Brazilian women. Methods A prospective observational study evaluated the initial management offered by the gynecologist in the case of 2,458 ASCs cytology results collected between January of 2010 and July of 2016. The outcomes of the cytology, high-risk human papilloma virus (HR-HPV) test and histology were compared in two subgroups: atypical squamous cells of undetermined significance (ASC-US) and atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H). Results In many cases of ASC-US (36.97%) and ASC-H (40.50%), no clinical actions were taken. Cytology was the most frequent follow-up chosen, including for cases of ASC-H, which goes against the conduct recommended in the national guideline. In women over 30 years of age, the period of time elapsed between an ASC-US result and a new cytology was in 13.03 months, in disagreement with the national guideline recommendations (p< 0.0001). Negative for intraepithelial lesions or malignancy (NILM) cytologic (p = 0.0026) and histologic (p = 0.0017) results in the follow-up were associated with prior ASC-US, while negative results for ASC-H were cytologically (p< 0.0001) and histologically associated with high-grade squamous intraepithelial lesion (HSIL) (p< 0.0001). Two invasive cervical carcinomas (ICCs) were found in the follow-up for ASC-H, and there was a statistically significant association (p = 0.0341). A positive HR-HPV test was associated with ASC-H (p = 0.0075). Conclusion The data suggest that even for a population of Brazilian women assisted at private clinics, the national guidelines recommendations for ASCs results are not followed.Federação Brasileira das Sociedades de Ginecologia e Obstetrícia2018-03-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032018000300121Revista Brasileira de Ginecologia e Obstetrícia v.40 n.3 2018reponame:Revista brasileira de ginecologia e obstetrícia (Online)instname:Federação Brasileira das Sociedades de Ginecologia e Obstetrícia (FEBRASGO)instacron:FEBRASGO10.1055/s-0038-1639466info:eu-repo/semantics/openAccessOliveira,Geilson Gomes deOliveira,Judite Maria da Silva Costa deEleutério,Renata Mirian NunesEleutério Júnior,Joséeng2018-05-30T00:00:00Zoai:scielo:S0100-72032018000300121Revistahttp://www.scielo.br/rbgohttps://old.scielo.br/oai/scielo-oai.phppublicações@febrasgo.org.br||rbgo@fmrp.usp.br1806-93390100-7203opendoar:2018-05-30T00:00Revista brasileira de ginecologia e obstetrícia (Online) - Federação Brasileira das Sociedades de Ginecologia e Obstetrícia (FEBRASGO)false
dc.title.none.fl_str_mv Management of Atypical Squamous Cell Cases: A Prospective Study of Women seen at a Private Health Service in Northeastern Brazil
title Management of Atypical Squamous Cell Cases: A Prospective Study of Women seen at a Private Health Service in Northeastern Brazil
spellingShingle Management of Atypical Squamous Cell Cases: A Prospective Study of Women seen at a Private Health Service in Northeastern Brazil
Oliveira,Geilson Gomes de
uterine cervical neoplasm
disease management
atypical squamous cells of the cervix
papanicolaou test
human papillomavirus
title_short Management of Atypical Squamous Cell Cases: A Prospective Study of Women seen at a Private Health Service in Northeastern Brazil
title_full Management of Atypical Squamous Cell Cases: A Prospective Study of Women seen at a Private Health Service in Northeastern Brazil
title_fullStr Management of Atypical Squamous Cell Cases: A Prospective Study of Women seen at a Private Health Service in Northeastern Brazil
title_full_unstemmed Management of Atypical Squamous Cell Cases: A Prospective Study of Women seen at a Private Health Service in Northeastern Brazil
title_sort Management of Atypical Squamous Cell Cases: A Prospective Study of Women seen at a Private Health Service in Northeastern Brazil
author Oliveira,Geilson Gomes de
author_facet Oliveira,Geilson Gomes de
Oliveira,Judite Maria da Silva Costa de
Eleutério,Renata Mirian Nunes
Eleutério Júnior,José
author_role author
author2 Oliveira,Judite Maria da Silva Costa de
Eleutério,Renata Mirian Nunes
Eleutério Júnior,José
author2_role author
author
author
dc.contributor.author.fl_str_mv Oliveira,Geilson Gomes de
Oliveira,Judite Maria da Silva Costa de
Eleutério,Renata Mirian Nunes
Eleutério Júnior,José
dc.subject.por.fl_str_mv uterine cervical neoplasm
disease management
atypical squamous cells of the cervix
papanicolaou test
human papillomavirus
topic uterine cervical neoplasm
disease management
atypical squamous cells of the cervix
papanicolaou test
human papillomavirus
description Abstract Objective To assess the management chosen by gynecologists after atypical squamous cells (ASCs) cytology results, and to evaluate the outcomes of these cases in Brazilian women. Methods A prospective observational study evaluated the initial management offered by the gynecologist in the case of 2,458 ASCs cytology results collected between January of 2010 and July of 2016. The outcomes of the cytology, high-risk human papilloma virus (HR-HPV) test and histology were compared in two subgroups: atypical squamous cells of undetermined significance (ASC-US) and atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H). Results In many cases of ASC-US (36.97%) and ASC-H (40.50%), no clinical actions were taken. Cytology was the most frequent follow-up chosen, including for cases of ASC-H, which goes against the conduct recommended in the national guideline. In women over 30 years of age, the period of time elapsed between an ASC-US result and a new cytology was in 13.03 months, in disagreement with the national guideline recommendations (p< 0.0001). Negative for intraepithelial lesions or malignancy (NILM) cytologic (p = 0.0026) and histologic (p = 0.0017) results in the follow-up were associated with prior ASC-US, while negative results for ASC-H were cytologically (p< 0.0001) and histologically associated with high-grade squamous intraepithelial lesion (HSIL) (p< 0.0001). Two invasive cervical carcinomas (ICCs) were found in the follow-up for ASC-H, and there was a statistically significant association (p = 0.0341). A positive HR-HPV test was associated with ASC-H (p = 0.0075). Conclusion The data suggest that even for a population of Brazilian women assisted at private clinics, the national guidelines recommendations for ASCs results are not followed.
publishDate 2018
dc.date.none.fl_str_mv 2018-03-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032018000300121
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032018000300121
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1055/s-0038-1639466
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
publisher.none.fl_str_mv Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
dc.source.none.fl_str_mv Revista Brasileira de Ginecologia e Obstetrícia v.40 n.3 2018
reponame:Revista brasileira de ginecologia e obstetrícia (Online)
instname:Federação Brasileira das Sociedades de Ginecologia e Obstetrícia (FEBRASGO)
instacron:FEBRASGO
instname_str Federação Brasileira das Sociedades de Ginecologia e Obstetrícia (FEBRASGO)
instacron_str FEBRASGO
institution FEBRASGO
reponame_str Revista brasileira de ginecologia e obstetrícia (Online)
collection Revista brasileira de ginecologia e obstetrícia (Online)
repository.name.fl_str_mv Revista brasileira de ginecologia e obstetrícia (Online) - Federação Brasileira das Sociedades de Ginecologia e Obstetrícia (FEBRASGO)
repository.mail.fl_str_mv publicações@febrasgo.org.br||rbgo@fmrp.usp.br
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