Risk of high-grade cervical dysplasia and gynaecological malignancies following the cytologic diagnosis of atypical endocervical cells of undetermined significance: A retrospective study of a state-wide screening population in Western Australia

Background: In 2006, Australia adopted a revised cervical cytology terminology system, known as the Australian Modified Bethesda System (AMBS). One substantial change in the AMBS was the introduction of the diagnostic category of atypical endocervical cells (AEC) of undetermined significance. Aim:...

Full description

Bibliographic Details
Main Authors: Munro, A., Williams, Vincent, Semmens, James, Leung, Y., Stewart, C., Codde, Jim, Spilsbury, Katrina, Steel, N., Cohen, P., O'Leary, Peter
Format: Journal Article
Published: Wiley-Blackwell Publishing Asia 2015
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/26020
_version_ 1848751867583004672
author Munro, A.
Williams, Vincent
Semmens, James
Leung, Y.
Stewart, C.
Codde, Jim
Spilsbury, Katrina
Steel, N.
Cohen, P.
O'Leary, Peter
author_facet Munro, A.
Williams, Vincent
Semmens, James
Leung, Y.
Stewart, C.
Codde, Jim
Spilsbury, Katrina
Steel, N.
Cohen, P.
O'Leary, Peter
author_sort Munro, A.
building Curtin Institutional Repository
collection Online Access
description Background: In 2006, Australia adopted a revised cervical cytology terminology system, known as the Australian Modified Bethesda System (AMBS). One substantial change in the AMBS was the introduction of the diagnostic category of atypical endocervical cells (AEC) of undetermined significance. Aim: The aim of this study was to investigate the incidence of histologically confirmed high-grade cervical dysplasia (cervical intra-epithelial neoplasia (CIN) grades 2 and 3 and adenocarcinoma in situ (ACIS)), cervical carcinoma and endometrial carcinoma in women presenting with AEC on cervical cytology. Methods: A seven-year retrospective study examining clinical outcomes of women with AEC on a screening cervical smear. Cytology and histology results were extracted from the Western Australia Cervical Screening Registry, and time-to-event analysis was used to predict the odds of having or developing in situ and invasive neoplasia.Results: AEC was reported in index smears from 0.093% (584/622754) women during the study period. No follow-up was available in 35 AEC cases. Sixty-five of the remaining 549 women (11.8%) had, or developed, high-grade cervical dysplasia within five years of their index AEC diagnosis. Endometrial cancer was diagnosed in 21 women and cervical cancer in four women during the follow-up period. Conclusion: Cytologic demonstration of AEC requires careful gynaecologic evaluation, particularly in younger women who may be found to have either high-grade squamous (CIN) or glandular (ACIS) lesions, while in older women, the possibility of endometrial neoplasia needs to be considered.
first_indexed 2025-11-14T07:59:33Z
format Journal Article
id curtin-20.500.11937-26020
institution Curtin University Malaysia
institution_category Local University
last_indexed 2025-11-14T07:59:33Z
publishDate 2015
publisher Wiley-Blackwell Publishing Asia
recordtype eprints
repository_type Digital Repository
spelling curtin-20.500.11937-260202018-06-13T06:59:52Z Risk of high-grade cervical dysplasia and gynaecological malignancies following the cytologic diagnosis of atypical endocervical cells of undetermined significance: A retrospective study of a state-wide screening population in Western Australia Munro, A. Williams, Vincent Semmens, James Leung, Y. Stewart, C. Codde, Jim Spilsbury, Katrina Steel, N. Cohen, P. O'Leary, Peter Papanicolaou smear cervical screening atypical glandular cells cervical cytology endometrial cancer cervical cancer atypical endocervical cells Background: In 2006, Australia adopted a revised cervical cytology terminology system, known as the Australian Modified Bethesda System (AMBS). One substantial change in the AMBS was the introduction of the diagnostic category of atypical endocervical cells (AEC) of undetermined significance. Aim: The aim of this study was to investigate the incidence of histologically confirmed high-grade cervical dysplasia (cervical intra-epithelial neoplasia (CIN) grades 2 and 3 and adenocarcinoma in situ (ACIS)), cervical carcinoma and endometrial carcinoma in women presenting with AEC on cervical cytology. Methods: A seven-year retrospective study examining clinical outcomes of women with AEC on a screening cervical smear. Cytology and histology results were extracted from the Western Australia Cervical Screening Registry, and time-to-event analysis was used to predict the odds of having or developing in situ and invasive neoplasia.Results: AEC was reported in index smears from 0.093% (584/622754) women during the study period. No follow-up was available in 35 AEC cases. Sixty-five of the remaining 549 women (11.8%) had, or developed, high-grade cervical dysplasia within five years of their index AEC diagnosis. Endometrial cancer was diagnosed in 21 women and cervical cancer in four women during the follow-up period. Conclusion: Cytologic demonstration of AEC requires careful gynaecologic evaluation, particularly in younger women who may be found to have either high-grade squamous (CIN) or glandular (ACIS) lesions, while in older women, the possibility of endometrial neoplasia needs to be considered. 2015 Journal Article http://hdl.handle.net/20.500.11937/26020 10.1111/ajo.12336 Wiley-Blackwell Publishing Asia unknown
spellingShingle Papanicolaou smear
cervical screening
atypical glandular cells
cervical cytology
endometrial cancer
cervical cancer
atypical endocervical cells
Munro, A.
Williams, Vincent
Semmens, James
Leung, Y.
Stewart, C.
Codde, Jim
Spilsbury, Katrina
Steel, N.
Cohen, P.
O'Leary, Peter
Risk of high-grade cervical dysplasia and gynaecological malignancies following the cytologic diagnosis of atypical endocervical cells of undetermined significance: A retrospective study of a state-wide screening population in Western Australia
title Risk of high-grade cervical dysplasia and gynaecological malignancies following the cytologic diagnosis of atypical endocervical cells of undetermined significance: A retrospective study of a state-wide screening population in Western Australia
title_full Risk of high-grade cervical dysplasia and gynaecological malignancies following the cytologic diagnosis of atypical endocervical cells of undetermined significance: A retrospective study of a state-wide screening population in Western Australia
title_fullStr Risk of high-grade cervical dysplasia and gynaecological malignancies following the cytologic diagnosis of atypical endocervical cells of undetermined significance: A retrospective study of a state-wide screening population in Western Australia
title_full_unstemmed Risk of high-grade cervical dysplasia and gynaecological malignancies following the cytologic diagnosis of atypical endocervical cells of undetermined significance: A retrospective study of a state-wide screening population in Western Australia
title_short Risk of high-grade cervical dysplasia and gynaecological malignancies following the cytologic diagnosis of atypical endocervical cells of undetermined significance: A retrospective study of a state-wide screening population in Western Australia
title_sort risk of high-grade cervical dysplasia and gynaecological malignancies following the cytologic diagnosis of atypical endocervical cells of undetermined significance: a retrospective study of a state-wide screening population in western australia
topic Papanicolaou smear
cervical screening
atypical glandular cells
cervical cytology
endometrial cancer
cervical cancer
atypical endocervical cells
url http://hdl.handle.net/20.500.11937/26020