Comparison of cervical cytological screening results between postmenopausal and elderly women

There is insufficient data on geriatric period cervical cytology screening in our country. The aim of this study was to compare the cervical cytological results among elderly women and women aged between 45-64 years.

A comparison of cervical cytological results of 273 women aged over 65 years and 388 women aged between 45-64 years from January 2010 to June 2013 was performed for presence of cytological abnormalities. Adequacy was assessed according to the criteria of the 2001 Bethesda System. Cervical cytological abnormalities were classified as follows: atypical squamous cell of undetermined significance (ASCUS), cannot exclude a high-grade squamous intraepithelial lesion (ASC-H), low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesion (HSIL) and squamous cell carcinoma (SSC).

Overall, the prevalence of cytological abnormality was 3% and the prevalence of ASCUS, ASCH, LSIL, and HSIL was 1.8%, 0.3%, 0.6% and 0.3%, respectively. Cytological abnormalities were detected to be higher in the geriatric group in comparison to the postmenopausal group (%5.1 vs. %1.5) (p=0.008). ASCUS was detected to be 3.7% in the geriatric group and 0.5% in the postmenopausal group (p=0.005). There was no statistically significant difference between the groups in means of other cytological anomalies. The reactive inflammatory changes were detected more in the postmenopausal group and atrophic changes in the geriatric group (p < 0.001).

It should not be forgotten that although the cervical screening follow-up program is discontinued in elderly women, squamous intraepithelial lesions can still be encountered in this group even if the rate is low.