Five-year follow-up of women with borderline and mildly dyskaryotic cervical smears.

This study investigated the 5-year follow-up status of women with cervical smears showing borderline nuclear changes (BNC) or mild dyskaryosis and the effect of koilocytosis on the outcome. Thirteen per cent of women with cervical smears showing BNC had high-grade cervical intraepithelial neoplasia (CIN). In contrast, 28% of women with cervical smears showing mild dyskaryosis had high-grade CIN. The presence of koilocytosis (24% for borderline smears and 34% for mild dyskaryotic smears) did not appear to influence the risk of developing high-grade CIN. Our results suggest that the simultaneous implementation of the British Society for Clinical Cytology proposed terminology and the colposcopy guidelines from the British Society for Colposcopy and Cervical Pathology could have an impact on colposcopy services.

A cervical smear review in women developing cervical carcinoma with particular reference to age, false negative cytology and the histologic type of the carcinoma.

A review of all available cervical smears from 96 women who subsequently developed invasive cervical carcinoma was undertaken. The aim of the study was to determine the incidence of confirmed negative smears prior to the histologic diagnosis of carcinoma and investigate the relationship between the duration and grade of smear abnormality, the patients' age and the histologic types of cervical carcinoma. The results indicate that only 10% of women had confirmed negative smears, the majority occurring more than 7 years before the diagnosis of carcinoma. In contrast, 89% of young women (under 40 years of age) had a significant abnormality (moderate dyskaryosis or worse) up to 6 years before diagnosis. There is evidence to suggest that the preinvasive phase of cervical carcinoma may be shorter in younger women and that the less common types of cervical carcinoma occur more frequently in this group. The combination of inadequate clinical follow up and false negative cytology may have allowed a significant proportion of these women to develop invasive cervical carcinoma. Possible reasons for false negative smears have been identified and methods aimed at decreasing their frequency are discussed.