Association between concurrent genital bleeding and cervical cancer: a cross-sectional study

作者：Xavier Junior Jose C C; Vale Diama B; Zeferino Luiz C; dufloth Rozany M^*

来源：Acta Obstetricia et Gynecologica Scandinavica, 2015, 94(9): 949-953.

DOI：10.1111/aogs.12682

• Uterine cervical neoplasms
• papanicolaou test
• early detection of cancer
• age
• abnormal uterine bleeding

IntroductionGenital bleeding may be a common symptom among women with cervical cancer.
Material and methodsCross-sectional study evaluating whether the prevalence of cervical smear results is different in women with and without clinical information about concurrent genital bleeding.
ResultsThe sample consisted of 2324836 smears; of these, 0.4% had clinical information on genital bleeding. When stratified by age group, women with genital bleeding had a higher chance of a cytological result of a high-grade squamous intraepithelial lesion [30-49years odds ratio (OR) 2.38; 95% confidence interval (CI) 1.60-3.53 and 50years OR 6.30; 95%CI 3.72-10.67), of squamous cell carcinoma (SCC) (30-49years OR 24.70; 95%CI 11.96-51.03 and 50years OR 48.91; 95%CI 31.28-76.47) and of atypical glandular cells (30-49years OR 5.72; 95%CI 3.30-9.93 and 50years OR 11.56; 95%CI 5.96-22.45); there was also a higher chance of adenocarcinoma for women 50years (OR 53.13; 95%CI 28.08-100.51). The sensitivity of genital bleeding for women aged 18-29years was 0.4% for high-grade squamous intraepithelial lesion (HSIL); for women 30-49years old the rate was 0.9% for HSIL, 8.6% for SCC and 2.1% for atypical glandular cells of undetermined significance (AGUS), while for women aged from 50years or more the rates were 2.0% for HSIL, 13.7% for SCC, 3.6% for AGUS and 14.7% for adenocarcinoma.
ConclusionWomen 30years old with genital bleeding should be referred for colposcopy to rule out the possibility of cervical cancer.

• 出版日期2015-9