Risk of gynaecological malignancies in cytologically atypical glandular cells: follow-up study of a nationwide screening population
Article first published online: 4 NOV 2010
© 2010 The Authors Journal compilation © RCOG 2010 BJOG An International Journal of Obstetrics and Gynaecology
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 118, Issue 1, pages 34–41, January 2011
How to Cite
Cheng, W.-F., Chen, Y.-L., You, S.-L., Chen, C.-J., Chen, Y.-C., Hsieh, C.-Y. and Chen, C.-A. (2011), Risk of gynaecological malignancies in cytologically atypical glandular cells: follow-up study of a nationwide screening population. BJOG: An International Journal of Obstetrics & Gynaecology, 118: 34–41. doi: 10.1111/j.1471-0528.2010.02769.x
- Issue published online: 10 DEC 2010
- Article first published online: 4 NOV 2010
- Accepted 21 September 2010. Published Online 4 November 2010.
- Atypical glandular cell;
- cervical cancer;
- ovarian cancer;
- Papanicolaou smear;
- uterine cancer
Please cite this paper as: Cheng W-F, Chen Y-L, You S-L, Chen C-J, Chen Y-C, Hsieh C-Y, Chen C-A. Risk of gynaecological malignancies in cytologically atypical glandular cells: follow-up study of a nationwide screening population. BJOG 2011;118:34–41.
Objective To investigate the relationship between screening status, clinical characteristics and risk of gynaecological malignancies in women with a cytological diagnosis of atypical glandular cells (AGC).
Design Prospective study of a screened population.
Population Case series from nationwide screening population.
Methods The 8281 women who were diagnosed with cytological AGC for the first time were divided into screened (5386 women) and unscreened (2895 cases) groups according to their screening status. Follow-up histological reports were analysed.
Main outcome measures Diagnosis of cervical, uterine, or ovarian cancers.
Results Of the 323 women who developed gynaecological malignancies, 271 had invasive cervical cancers, 40 had uterine cancers and 12 had ovarian cancers, with a mean follow up of 1.9 years and 50 740 person-years. Previous screening status was a strong risk predictor of gynaecological malignancies (hazard ratio 1.69, P = 0.0027). Compared with the general screening population, women with a first diagnosis of cytological AGC had significantly increased ratios of developing gynaecological malignancies (17.85-fold for cervical cancer, 5.68-fold for uterine cancer, and 2.04-fold for ovarian cancer, P < 0.05). When compared with women aged <35 years, those in other age groups had a significantly higher risk of developing gynaecological cancers (age ≥60 years, hazard ratio 1.99, 95% CI 1.20–2.37, P = 0.016).
Conclusions Comprehensive evaluation for women with cytological AGC, including pelvic examination, ultrasonography, colposcopy, endocervical curettage, cervical biopsy and endometrial biopsy needs to be considered, especially for those with risk factors (i.e. >60 years old, lower educational status, previous Papanicolaou smear interval longer than 2 years, or no previous Papanicolaou smear).