ABSTRACT
The first atypical Papanicolaou smear in young, sexually active Latino and African-American women of low socioeconomic status may be predictive of underlying cervical neoplasia and human papillomavirus infection of significant quantity. The optimal management of first-time atypia on routine Pap smear has not been established. In many clinics, colposcopically directed sampling of the cervix is recommended only if atypia persists following specific or nonspecific treatment of cervicitis or after an arbitrarily determined time interval. Others recommend immediate colposcopic evaluation. To determine the best approach to the first-time atypical Pap smear in young minority women at high risk for the development of cervical cancer, 250 such patients were evaluated with colposcopically directed biopsy of the cervix prior to any form of therapy. Pap smears were repeated at the time of colposcopy. Histologically, there was evidence of cervical intraepithelial neoplasia in 41% of patients and human papillomavirus infection in 86%. Repeat Pap smears predicted the presence of cervical intraepithelial neoplasia in only 24% of patients. Immediate colposcopic evaluation represents the most prudent approach to the first-time atypical Pap smear in young, high-risk minority women.
Subject(s)
Black or African American , Hispanic or Latino , Papanicolaou Test , Uterine Cervical Neoplasms/diagnosis , Vaginal Smears , Adolescent , Adult , Female , Humans , Papillomaviridae , Papillomavirus Infections/diagnosis , Papillomavirus Infections/ethnology , Predictive Value of Tests , Risk Factors , Tumor Virus Infections/diagnosis , Tumor Virus Infections/ethnology , Uterine Cervical Neoplasms/ethnology , Uterine Cervical Dysplasia/diagnosis , Uterine Cervical Dysplasia/ethnologyABSTRACT
A case of Rokitansky-Küster-Haüser syndrome was associated with a bizarre mesodermal "embryopathy" consisting of an unclassified renal tumor and associated congenital developmental anomalies.
