THE SIGNIFICANCE OF CERVICAL CYTOLOGIC DYSPLASIA

Abstract

The cytologic screening experience of the University of New Mexico Cytopathology Laboratory [Albuquerque, New Mexico, USA], was reviewed for 9 yr to evaluate the potential for progression of cervical squamous dysplasia to severe dysplasia and carcinoma. Entry conditions for dysplasia study were 2 initial negative smears to standardize the cytologic history to a reasonable extent. Relative likelihood of progression was calculated for 3 levels of cytologic dysplasia and was compared to those of negative and positive smears to ascertain the relative risk of the various levels of cytologic atypia. Slight, moderate and severe dysplasia were, respectively, 9.0, 26.3 and 83.3 times more likely than a negative smear to be followed by 1 positive for carcinoma or showing severe dysplasia. Histologic follow-up of study subjects was correlated with their cytologic history. Cytologic follow-up of patients with slight, moderate and severe dysplasia indicated a high spontaneous regression rate. Time for conversion from negative cytology to severe dysplasia or positive cytology for histologically confirmed cases averaged 3.0 yr. An unexpected finding was a 12.5% false-negative rate for severe dysplasia and positive cytology, indicating a need for caution in advising repeat smears in lieu of a biopsy for confirmation of these findings. [The significance of cytological dysplasia in relation to the natural history of uterine cervical carcinoma was discussed.].