Abstract
Background: Atypical glandular cells (AGC) are rare abnormalities found on cervical cytology associated with a range of lesions of the female reproductive system. We compared the risk of cervical and other gynecologic cancers following AGC on cervical cytology with the risk following squamous cell abnormalities of comparable severity. Methods: We used data from the Dutch Pathology Archive (PALGA) from 2000 to 2015 to categorize cervical cytology tests into groups based on most severe cytologic abnormality and correlated follow-up advice (normal cytology and "no follow-up"advice, squamous-cell-based, AGC-based, and combined AGC/squamouscell based each with either repeat testing or referral advice). Cancer data were linked from the Netherlands Cancer Registry. Cox proportional hazard models were calculated stratified by age [younger (<50 years) and older (50+ years)], adjusted for number of previous primary cytology tests. Results: 8,537,385 cytology smears and 9,061 cancers were included. When repeat cytology testing was advised, HRs of cervical cancer (younger women: HR, 6.91; 95% CI, 5.48-8.71; older women: HR, 3.98; 95% CI, 2.38-6.66) or other gynecologic cancer diagnosis in younger women (HR, 2.82; 95% CI, 1.39- 5.74) were significantly higher after an AGC-based abnormality compared with squamous-based abnormalities. Hazards were also significantly higher for "referral"advice cytology, except for cervical cancer among older women (HR, 0.88; 95% CI, 0.63-1.21). Conclusions: AGC indicates an increased risk of gynecologic cancer compared with squamous-based abnormalities of comparable severity. Impact: Gynecologists should be alert for cervical and endometrial cancers when examining women referred following AGC.
| Original language | English |
|---|---|
| Pages (from-to) | 743-750 |
| Number of pages | 8 |
| Journal | Cancer Epidemiology Biomarkers and Prevention |
| Volume | 30 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 1 Apr 2021 |
Bibliographical note
Funding Information:We wish to thank Dr Nicolien van Ravesteyn for her helpful comments on our manuscript. This study was funded by the Dutch National Institute from Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu). This study was conducted as part of the Evaluation of the Dutch cervical cancer screening programme, which is funded by the Dutch National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu).
Funding Information:
C.A. Aitken and E.E.L. Jansen report grants from the National Institute of Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu) during the conduct of the study. No disclosures were reported by the other authors.
Publisher Copyright:
© 2021 American Association for Cancer Research.
