Prevalence and Description of High-Grade Intraepithelial Lesions of Cervical Mucosa Cells in a Screening Programme for Cervical Cancer in Isère, France.

Publisher: John Wiley & Sons Ltd Country of Publication: United States NLM ID: 101595310 Publication Model: Print Cited Medium: Internet ISSN: 2045-7634 (Electronic) Linking ISSN: 20457634 NLM ISO Abbreviation: Cancer Med Subsets: MEDLINE

Original Publication: [Malden, MA] : John Wiley & Sons Ltd., c2012-

Uterine Cervical Neoplasms*/epidemiology ; Uterine Cervical Neoplasms*/diagnosis ; Uterine Cervical Neoplasms*/pathology ; Uterine Cervical Neoplasms*/virology ; Early Detection of Cancer*/methods ; Uterine Cervical Dysplasia*/epidemiology ; Uterine Cervical Dysplasia*/diagnosis ; Uterine Cervical Dysplasia*/pathology ; Uterine Cervical Dysplasia*/virology ; Vaginal Smears*/methods ; Colposcopy*; Humans ; Female ; Middle Aged ; Adult ; France/epidemiology ; Prevalence ; Aged ; Neoplasm Grading ; Cervix Uteri/pathology ; Papillomavirus Infections/epidemiology ; Papillomavirus Infections/virology ; Papillomavirus Infections/diagnosis ; Biopsy ; Mass Screening/methods

Objective: This study aims to analyse high-grade intraepithelial lesions (LIEHG) observed in a screening programme from 2010 to 2018 to more accurately describe them and formulate recommendations for best practices in the context of screening evolution following the introduction of an HPV test in primary cervical cancer screening in 2020.
Methods: This study included 305,940 asymptomatic women aged 25-65 years. The eligible population was invited to undergo a screening cervico-uterine-smear every 3 years. If this smear was normal, the woman received a new invitation. In the case of a positive screen, the patient underwent further diagnostic procedures, such as colposcopy and biopsy to confirm the diagnosis. Only those diagnosed with LIEHG and above proceeded to treatment. The diagnoses associated with LIEHG were those related to the WHO Classification of tumours of the uterine cervix.
Results: Positive smears led to the diagnosis of 3230 LIEHG. The prevalence of LIEHG in the screened population was 0.4%. The LIEHG distribution varied significantly according to the age of the women. The probability of diagnosing LIEHG in young women was 12.2% at 25-29 years. This probability decreased by half after 50 years. We observed that the type of smear was significantly associated with LIEHG detection. The positive predictive value for diagnosing LIEHG was 70.3% for high-grade squamous intraepithelial lesion (HSIL) smears and 35.1% for atypical squamous cells cannot exclude HSIL (ASC-H) smears.
Conclusion: In the study population, the prevalence of LIEHG was high in women under 35 years. Low-grade smears were correlated with the risk of LIEHG and should prompt screening facilities to allocate resources to ensure active follow-up of LSIL and ASC-US smears. Adherence to cytological screening recommendations was associated with a reduced risk of LIEHG in multivariate analysis.
(© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.)

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Keywords: HPV; cervical cancer screening; cervical pap smear; high‐grade intraepithelial lesions; prevalence; uterine cervical neoplasms

Date Created: 20241014 Date Completed: 20241014 Latest Revision: 20241016

20250114

PMC11472336

10.1002/cam4.70259

39400464