Postcoital bleeding is a predictor for cervical dysplasia

Omer Cohen1, Edwardo Schejter2, Regina Agizim1,2

  • 1Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel.

Plos One
|May 24, 2019
PubMed

Insights

Postcoital bleeding (PCB) may indicate cervical dysplasia, particularly in women with abnormal Pap smears. Colposcopy is recommended, especially for nulliparous women, to assess risk factors for cervical cancer.

Area of Science:

  • Gynecology
  • Oncology
  • Pathology

Background:

  • Postcoital bleeding (PCB) is a frequent gynecological complaint with unclear management guidelines.
  • Existing literature lacks definitive recommendations for evaluating PCB.

Purpose of the Study:

  • To determine risk factors for cervical dysplasia and cancer in patients experiencing postcoital bleeding (PCB).
  • To identify specific patient characteristics associated with adverse cervical pathology following PCB.

Main Methods:

  • A retrospective review of 411 women with PCB from a large health maintenance organization (HMO) database (2012-2015).
  • Data collected included patient demographics, obstetric history, BMI, smoking status, Pap smear results, colposcopy, and biopsy findings.
  • Cases were matched by age and socioeconomic status to controls undergoing routine care.

Main Results:

  • PCB incidence was highest in women aged 26-30.
  • Of 411 PCB cases, 48.9% underwent biopsy, revealing cervicitis (33.8%), CIN 1/koilocytosis (30.3%), and cervical polyps (12.4%).
  • Multiparous women had reduced risk (OR 0.39), while abnormal Pap smears significantly increased risk (OR 3.3) for CIN 1 or higher.
  • PCB patients were more likely to have CIN 1 or higher pathology (OR 1.82) compared to controls.

Conclusions:

  • Postcoital bleeding (PCB) warrants further investigation, including colposcopy, particularly in nulliparous women.
  • An abnormal Pap smear in conjunction with PCB is a significant risk factor for cervical dysplasia.
  • Multiparous status appears protective against significant cervical pathology in PCB patients.
Abstract