Evaluation of Cervical Cytology for Postmenopausal Women

Oh, S K; Lee, C M; Lee, J S; Kim, Y W; Choi, Y D; Nam, S I; Park, J H; Koh, B H

Abstract

Cervical cytology has been proven to be the best efficacious and cost-effective method for cancer screening. But false-negative rates for Pap smears are estimated to be 8~50%, and sometimes the transformation zone is not fully visualized on colposcopy, especially in postmenopausal women. We compared 240 squamous cell abnormalities on Pap smear with histologic results based on menopausal status in the department of Obstetrics & Gynecology, Gachon Medical College, Gil Medical Center from January 1996 to December 1996. The results were as follows ; 1. Of the 240 squamous cell abnormalities with histologic results, 66 (27.5%)cases were diagnosed as ASCUS, 45 (18.8%) as LSIL, 90 (37.5%) as HSIL and 39 (16.3%) as SCC. 2. ASCUS, LSIL and HSIL were highest in those at the age of 30`s and SCC was highest in those at the age of 50`s. 3. Comparing the cervical cytology with histology based on menopausal status, the discrepancy of more than one grade between them was significant in postmenopausal women with ASCUS and LSIL (p<0.05). According to our result and thorough review of the recent articles, management of low-grade cytologic abnormalities in postmenopausal women should be reevaluated and ancillary screening program should be considered.