Comparison of Histopathologic Stages of Asymptomatic and Symptomatic Cervical Neoplasm Patients

Yim, Hyeon Woo; Lee, Won Chul; Hwang, In Young; Kwon, Yong Il; Park, Jong Sup; Kim, Hoon Kyp

Abstract

Screening is for the early detection and treatment of diseases in prior to development of symptoms, so that more favourable prognosis could be obtained. To evaluate efficiency of screening test for cervical neoplasms, we compared the histopathologic stages of asymptomatic cervical neoplasm patients diagnosed by screening test, with those of symptomatic patients confirmed by pathology. Total 1,120 cases of cervical neoplasm patient, diagnosed at Kang-nam St. Mary's hospital from Jan. 1990 to Dec. 1996, were reviewed by chart, and classified as asymptomatic and symptomatic group based on the presence of subjective symptoms on their hospital visit. Their histopathologic stages were analysed. The results were as follows, 1. From the total of 1,120 patient, asymptomatic group comprised 264 cases (25.5%). Asymptomatic proportion increased 15.3% in 1991 to 34.7% in 1996. 2. Mean age for the occurrence of cervical neoplasm was 44.3 +/- 10.4 years for the asymptomatic group, and 49.3+/-13.2 years for the symptomatic group, showing statistically significant differences(p=0.001). 3. Among the study subjects, 465 cases(45.0%) had CIS(carcinoma in situ), and 569 cases(55.0%) had invasive cancers. 4. Percentage of cervical neoplasm patient diagnosed at asymptomatic stages were 45.8% in twenties, 32.0% in thirties, 27.7 % in forties, 21.7% in fifties, 18.7% in sixties and 1.8% in above seventies, showing statistically significant differences according to age group(p=0.001). 5. In thirties, 87.2% of the asymptomatic patients were diagnosed as CIS and 45.0% of symptomatic patient were diagnosed as CIS. With increment of ages, CIS proportion were markedly decreased. 6. 76.9% of asymptomatic patients were diagnosed as CIS, and 34.0 % of symptomatic patients were diagnosed as CIS, suggesting screening test at asymptomatic stage can increase CIS proportion. 7. CIS proportion of asymptomatic patient was highest in thirties(40.4%) and 2nd highest in forties(34.0%). Screening test for cervical neoplasm should be actively carried out from the thirties.