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[Cell anomalies in the cervix and subsequent pre-cancerous lesions in a Health Area]
Y Schmolling Guinovart1, J J Barquín Solera, A Zapata Ingelmo
1Centro de Salud La Solana, Unidad Docente de Medicina Familiar y Comunitaria de Talavera de la Reina, Toledo, Spain.
Objective:
To determine the frequency of epithelial anomalies in cervical smears during the three years from August 1997 to July 2000 and of subsequent pre-cancerous lesions that are histologically confirmed, with differentiation also being made between health care levels.
Design:
Retrospective descriptive study.
Setting:
Anatomy Pathology referral Laboratory. Talavera de la Reina Health Area.
Participants:
5,712 cervical smears and 70 biopsies.Intervention. Review of path reports.
Main Measurements And Results:
308 (5.4%) smears showed anomalies that were not attributed to a benign process. 209 (68%) of these were followed up, 139 (45%) of them through repetition of the smear and 70 (23%) through biopsy. Cell and cytology correlated in 42 women (30.2%), and cell-histology in 27 (38.6%) (0.47%, n = 5,712). 2,874 of the smears in the Area were taken in Primary Care, and 127 (22.2%) cell anomalies and 6 (0.1%) pre-cancerous lesions were found at this health care level.
Conclusions:
The 5.4% frequency of anomalies is consistent with that in other population groups with an incidence of cervical cancer similar to ours. The 0.47% pre-cancerous lesions confirmed histologically is very low in comparison with the anomalies, which suggests that this intervention needs to be improved. This could be done by increasing biopsies for cell anomalies and screening of women at risk. Interpretation of smear reports, more information to the women and follow-up of the findings could all be improved, too.