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Adolescent girls' understanding of Papanicolaou smear results
F M Biro1, S L Rosenthal, L Rymarquis
1Department of Pediatrics, University of Cincinnati College of Medicine, Ohio 45229, USA.
Study Objective:
Human papillomavirus (HPV) urogenital infections are common in sexually active adolescents. Previous research has indicated that adolescent girls do not reliably report histories of HPV infection. This study examined whether asking an adolescent girl if she had ever had an abnormal Papanicolaou (PAP) smear was a good screening question for evidence of HPV urogenital infection.
Design:
The responses to the question about abnormal PAP smears, were compared with their charts for documented abnormal PAP smear, HPV infection, and sexually transmitted infection.
Setting:
An urban, hospital-based adolescent clinic.
Participants:
Fifty adolescent girls (mean age, 14.8 years).
Main Outcome Measures:
Degree of agreement (kappa statistic).
Results:
Using a kappa statistic, reported history of an abnormal PAP smear had "fair" agreement with documented dysplasia on PAP smear and "moderate" agreement with documented HPV infection (i.e., either condyloma on PAP smear or genital warts noted on examination). This reported history of an abnormal PAP smear agreed better with documented HPV infection than with documented dysplasia on PAP smear.
Conclusions:
There appears to be considerable confusion among adolescent girls regarding their PAP smear results. Care providers need to be sensitive to this when they are collecting historical information and when they are diagnosing HPV infection or an abnormal PAP smear.
