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EP382/#190  Limitations of cervical cytology as a screening test in the diagnosis of cervical cancer
  1. Kosuke Shigematsu,
  2. Tomonori Nagai,
  3. Souichirou Kasiwabara,
  4. Yuuichirou Kizaki,
  5. Yoshiko Kurose,
  6. Kouki Samejima,
  7. Takahiro Uotani and
  8. Yasushi Takai
  1. Saitama Medical Center, Saitama Medical University, Department of Obstetrics and Gynecology, Kawagoe-shi, Saitama, Japan


Introduction In Japan’s Cervical Cancer Screening Guidelines (2020), the cervical cytology alone method is recommended to be performed every 2 years as a cervical cancer screening. On the other hand, its sensitivity and specificity are varied, respectively, and approximately 6% of the results are false-negative. In this study, we investigated the status of cervical cancer screening in the 2 years prior to diagnosis in our cervical cancer cases, and examined risk factor(s) for underestimation by screening.

Methods Cervical cancer patients who underwent initial treatment at our hospital between January 2012 and February 2022 were included in the study. Patient backgrounds (age at diagnosis, previous history, history of vaginal delivery, menstrual history, etc.) and cervical cancer screening status and results in the two years prior to diagnosis were extracted from medical records, and statistical analyses were conducted for patients whose cytological diagnosis was underestimated.

Results There were 323 cervical cancer cases during the study period. Of these, 22 patients (6.9%) were in the underestimated group who had undergone cervical cytology screening in the 2 years prior to diagnosis and had been diagnosed as normal. A history of cervical conization was found in 3 patients (13.6%) of the underestimated group and in 10 patients (3.3%) of the control group (n=301), which was statistically significant (p=0.0175).

Conclusion/Implications It is well known that cervical cancer screening is necessary even after conization for CIN3. Moreover, we hypothesize that results of cervical cytology screening alone may be underestimated in patients with a history of previous cervical conization.

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