Follow-Up of Women with Cervical Cytological Abnormalities: Progression and Regression Events

Abstract

Abnormalities in the cervix, when identified early by Pap smear, can be treated in the early stages or in the precursor<br />stages of the neoplasia, which may increase the chances of regression of the lesion. The aim to verify the rate of cervical<br />abnormalities and to evaluate the risk of progression or regression associated with age and cytological diagnosis.<br />Methods: The study was conducted in a referral hospital in Southern Brazil, based on the results of pathology and<br />cytopathology laboratory tests of uterine cervix. The historical cohort included patients with an abnormal cytology<br />diagnosis in the period from January 2010 to December 2014, followed until July 2016. Results: A total of 42,389<br />cervical smears were analyzed, 4,427 of which were eligible for analysis of the evolution of cervical abnormalities. In<br />progression and regression events analysis, we observed that patients with a cytological diagnosis of atypical glandular<br />cells presented a higher risk of cervical abnormality progression (Hazard Ratio: 2.0 and 95% confidence intervals<br />1.36–3.48). We also observed that patients younger than 25 years old were more likely to regress the cervical lesions<br />(Hazard Ratio:1.4 and 95% confidence intervals 1.20–1.74). Conclusions: The associations found between the events<br />(progression and regression), age and cytological diagnosis, highlights the importance of cytological screening in<br />populations at risk of precursor of cervical cancer lesions, especially in women older than 25 years.