Comparison of women with possible endocervical and non-cervical glandular neoplasms detected in liquid-based cervical cytology- incidence, clinical characteristics and outcomes: A cohort study

Mulholland, R., Yousef, H. M.S.A., Laing, M., Gupta, R. and Leung, E. Y.L. (2021) Comparison of women with possible endocervical and non-cervical glandular neoplasms detected in liquid-based cervical cytology- incidence, clinical characteristics and outcomes: A cohort study. European Journal of Obstetrics and Gynecology and Reproductive Biology, 257, pp. 100-105. (doi: 10.1016/j.ejogrb.2020.12.025) (PMID:33383409)

Abstract

Objective: To compare the incidence, demographics and clinical outcomes of women presenting with possible non-cervical (NC) and endocervical (EC) glandular neoplasms in their cervical smears. Study Design: Retrospective analysis of a prospective cohort within the NHS Greater Glasgow and Clyde- the largest health organisation in Scotland, UK. Methods: Cases identified from the Scottish Cervical Call Recall System between January 2013 and December 2017. Incidence and clinical trajectories of NC and EC were reviewed. Results: Two-hundred-and-thirty cases (NC = 41; EC = 189) from 486,240 smears were evaluated. The incidence was 8.4 and 38.9 per 100,000 smear-year for NC and EC, respectively. Compared to women with EC, women with NC were significantly older (p < 0.0001), had higher body mass index (p < 0.0001), more likely to present with symptoms (58.5 % vs 10.5 %; p < 0.0001), had cancers (48.8 % vs 13.8 %; p < 0.0001) and died from their diseases (9.8 % vs 0.5 %; p < 0.0001). Even in the asymptomatic screen-detected NC group, almost a quarter (23.5 %) had endometrial cancer. Age was not associated with high-risk histology (p = 0.289). High-risk colposcopic appearance had good positive predictive value (90.0 %; 95 %CI: 81.2–95.6 %) for high-risk histology, but poor negative predictive value (41.3 %; 95 %CI: 29–54 %). Negative excision margin was associated with favourable outcomes. Conclusions: NC and EC are rare, but they are distinct and should be reported separately in future studies. The risks of malignancies are high, particularly in women with NC, even if they are asymptomatic. Thus, prompt and thorough investigations and treatments are required to prevent and treat malignancies.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Leung, Dr Elaine

Creator Roles

Leung, E.: Conceptualization, Methodology, Data curation, Formal analysis, Visualization, Writing – original draft

• Authors: Mulholland, R., Yousef, H. M.S.A., Laing, M., Gupta, R., and Leung, E. Y.L.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: European Journal of Obstetrics and Gynecology and Reproductive Biology
• Publisher: Elsevier
• ISSN: 0301-2115
• ISSN (Online): 1872-7654
• Published Online: 15 December 2020
• Copyright Holders: Copyright © 2020 Elsevier
• First Published: First published in European Journal of Obstetrics and Gynecology and Reproductive Biology 257:100-105
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher