The accuracy of the Papanicolaou smear in the screening and diagnostic settings.

Abstract:

OBJECTIVE:We evaluated the performance of the Papanicolaou smear in screening and diagnostic settings. STUDY DESIGN:We analyzed Papanicolaou smear results of 1,850 women recruited into a clinical trial to evaluate an emerging technology for the detection of cervical cancer. Screening and diagnosis groups were based on the history of previous Papanicolaou smear results. We calculated sensitivities, specificities, positive and negative likelihood ratios (LR+ and LR-), receiver operating characteristic curves, and areas under the receiver operating characteristic curve (AUC). RESULTS:In the screening group, by defining disease as cervical intraepithelial neoplasia (CIN) 2,3/cancer or worse and using high-grade squamous intraepithelial lesion (HSIL) as the test cutpoint, the AUC was 0.689, and the LR+ and LR- were 39.25 and 0.67, respectively. In the diagnosis group, the AUC was 0.764, and the LR+ and LR- were 3.79 and 0.56, respectively. By defining disease as human papillomavirus/CIN 1 or worse and HSIL as the test cutpoint, the AUC was 0.586, and the LR+ and LR- were 17.01 and 0.92 in the screening group; in the diagnosis group, the AUC was 0.686, and the LR+ and LR- were 2.77 and 0.75, respectively. CONCLUSIONS:In a screening setting, a Papanicolaou smear result of HSIL or worse is 39 times more likely in a patient with CIN 2,3/cancer than in a patient without it. This compares to 4 times more likely in the diagnostic setting. The magnitude of the positive likelihood ratio observed in the screening group indicated that abnormal Papanicolaou smear results obtained in the screening setting should have more impact on clinical decision making than those from results obtained in the diagnostic setting.

journal_name

J Low Genit Tract Dis

authors

Cárdenas-Turanzas M,Follen M,Nogueras-Gonzalez GM,Benedet JL,Beck JR,Cantor SB

doi

10.1097/LGT.0b013e31816b44bc

subject

Has Abstract

pub_date

2008-10-01 00:00:00

pages

269-75

issue

4

eissn

1089-2591

issn

1526-0976

pii

00128360-200810000-00003

journal_volume

12

pub_type

临床试验,杂志文章,多中心研究
  • Giant epidermoid inclusion cyst of the clitoris mimicking clitoromegaly.

    abstract::We describe a rare case of clitoromegaly due to a large clitoral cyst that occurred spontaneously without any declared previous female genital mutilation. The cyst was excised successfully with good cosmetic results. ...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/LGT.0b013e318259a410

    authors: Al-Ojaimi EH,Abdulla MM

    更新日期:2013-01-01 00:00:00

  • Massive localized lymphedema of the vulva: report of a case and review of the literature.

    abstract:BACKGROUND:Massive localized lymphedema (MLL) is a recently described entity associated with obesity, most often on the thighs. It rarely occurs on the vulva, and it may pose diagnostic difficulty for both clinician and pathologist in this setting. CASE:An obese 55-year-old woman underwent excision of bilateral polypo...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章,评审

    doi:10.1097/LGT.0b013e31829cf432

    authors: Heller DS,Fitzhugh VA,Cracchiolo B,Barrett T Jr,Suidan RS

    更新日期:2014-04-01 00:00:00

  • History of Abuse in Women With Vulvar Pruritus, Vulvodynia, and Asymptomatic Controls.

    abstract:OBJECTIVE:Chronic vulvar pruritus and vulvodynia are common vulvar diseases. The aim of this study was to compare gynecologic and sexual and physical abuse histories from patients with these diagnoses and from healthy controls. MATERIALS AND METHODS:Questionnaires were self-completed by patients diagnosed with vulvar ...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/LGT.0000000000000075

    authors: Cohen-Sacher B,Haefner HK,Dalton VK,Berger MB

    更新日期:2015-07-01 00:00:00

  • Contribution of Exocervical Biopsy, Endocervical Curettage, and Colposcopic Grading in Diagnosing High-Grade Cervical Intraepithelial Neoplasia.

    abstract:OBJECTIVE:To determine the utility of random biopsy and endocervical curettage (ECC) during colposcopy among women who ultimately underwent cervical excisional biopsy. MATERIALS AND METHODS:In a retrospective observational study, the charts were reviewed of every patient who underwent cervical excisional procedure per...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/LGT.0b013e3182a5296e

    authors: Diedrich JT,Felix JC,Lonky NM

    更新日期:2016-01-01 00:00:00

  • Unusual locations of primary subepithelial squamous cell carcinomas of the vulva.

    abstract:OBJECTIVE:This study aimed to report 2 cases of squamous cell carcinoma (SCC) of the vulva, arising from unusual subepithelial locations. MATERIALS AND METHODS:The first case was of an 85-year-old woman with a 65-year history of a mass in the left labium majus. The second case was of a 54-year-old woman who presented ...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/LGT.0b013e31827a8c95

    authors: Scurry JP,Yu TT,Otton GR

    更新日期:2013-10-01 00:00:00

  • Fabric-based exocervical and endocervical biopsy in comparison with punch biopsy and sharp curettage.

    abstract:OBJECTIVES:Fabric-based endocervical and exocervical biopsy tools were compared with exocervical punch biopsy and sharp endocervical curettage. We compared the level of pain reported by the patient and the amount of bleeding rated by the physician relative to the type of biopsy used. MATERIALS AND METHODS:This was a 2...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/LGT.0b013e318234262d

    authors: Winter M,Cestero RM,Burg A,Felix JC,Han C,Raffo AM,Vasilev S

    更新日期:2012-04-01 00:00:00

  • Risk factors for progression or persistence of squamous intraepithelial lesions diagnosed during pregnancy.

    abstract:OBJECTIVE:This study aimed to assess the risk of progression/persistence of squamous intraepithelial lesions (SILs) during pregnancy according to the age of the woman, the grade of the lesion, the type of human papillomavirus (HPV) infection, and the mode of delivery. MATERIALS AND METHODS:Eighty pregnant women with a...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/LGT.0b013e31822e83cf

    authors: Cubo-Abert M,Centeno-Mediavilla C,Franco-Zabala P,Merced-Vázquez C,Castellví J,García A,Gil-Moreno A,Xercavins J

    更新日期:2012-01-01 00:00:00

  • Differences in cervical cytologic and histologic findings between women using depot-medroxyprogesterone acetate and oral contraceptives.

    abstract:OBJECTIVE:This study aimed to compare cervical cytologic and histologic findings between women using depot-medroxyprogesterone acetate (DMPA) and oral contraceptives (OCs) referred for colposcopy and to determine whether there were differences in the occurrence of false-positive cytologic finding between the 2 contrace...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/LGT.0b013e31820eb140

    authors: Clark MK,Stockdale CK,Railsback L,Nichols S

    更新日期:2011-07-01 00:00:00

  • Home study course: summer 2005.

    abstract:OBJECTIVE:The Home Study Course is intended for the practicing colposcopist or practitioner who is seeking to develop or enhance his or her colposcopic skills. The goal of the course is to present colposcopic cases that are unusual or instructive in terms of appearance, presentation, or management, or that demonstrate ...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/01.lgt.0000171660.77437.f2

    authors: Berry JM,Darragh TM

    更新日期:2005-07-01 00:00:00

  • Metronidazole vaginal gel 1.3% in the treatment of bacterial vaginosis: a dose-ranging study.

    abstract:OBJECTIVE:Metronidazole vaginal gel (MVG) 0.75% is a US Food and Drug Administration-approved, 5-day treatment for bacterial vaginosis (BV). This study tested the hypothesis that a shorter treatment course at a higher dose (MVG 1.3%) would yield similar efficacy to 5 days of MVG 0.75%. MATERIALS AND METHODS:This phase...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/LGT.0000000000000062

    authors: Chavoustie SE,Jacobs M,Reisman HA,Waldbaum AS,Levy SF,Hillier SL,Nyirjesy P

    更新日期:2015-04-01 00:00:00

  • Expression of p16INK4 and Rb Genes in Cervical Neoplasm.

    abstract:BACKGROUND:The molecular events surrounding the pathogenesis of human cervical cancer remain to be defined to a significant extent. The current study investigates the expression of two putative tumor suppressor genes p16 and Rb in cervical neoplasm. MATERIALS AND METHODS:Tissue was collected from 16 cervical intraepit...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/00128360-199710000-00008

    authors: Wong YF,Cheung TH,Chung TK,Chan MK,Chang AM

    更新日期:1997-10-01 00:00:00

  • Use of electronic medical record-based tools to improve compliance with cervical cancer screening guidelines: effect of an educational intervention on physicians' practice patterns.

    abstract:OBJECTIVE:This study aimed to determine whether electronic medical record (EMR)-based tools influence providers' compliance with guidelines for cervical cancer screening in adolescent (<21 y) patients. MATERIALS AND METHODS:Three EMR-based tools to educate providers on cervical cancer screening guidelines were impleme...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/LGT.0b013e3182607137

    authors: White P,Kenton K

    更新日期:2013-04-01 00:00:00

  • Pagetoid spread of bladder urothelial carcinoma to the vagina and vulva.

    abstract:OBJECTIVE:To study the clinicopathologic features of a rare disease of pagetoid urothelial intraepithelial neoplasia (PUIN) in the vulva. MATERIALS AND METHODS:We reviewed a case of PUIN in a Chinese woman with a long history of bladder urothelial carcinoma. RESULTS:The patient presented with vulvar pruritus for more...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/LGT.0000000000000020

    authors: Lu B,Liang Y

    更新日期:2015-01-01 00:00:00

  • Unusual location of vulvar basal cell carcinoma.

    abstract:BACKGROUND:Basal cell carcinoma (BCC) is a rare tumor of the vulva; it accounts for approximately 2% to 4% of vulvar cancer. CASE:A 73-year-old woman was referred because of a 2-cm ulcerative lesion on her perineum, near the anus. Punch biopsy showed BCC. She underwent wide local excision of tumor without any damage t...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/01.lgt.0000225898.37090.04

    authors: Nazari Z,Omranipour R

    更新日期:2006-10-01 00:00:00

  • Can recurrence of cervical cancer be predicted by human papillomavirus DNA in nodes or plasma?

    abstract:OBJECTIVE:To determine if human papillomavirus (HPV) DNA in pelvic lymph nodes or plasma of women with early-stage cervical cancer is a marker for recurrence. MATERIALS AND METHODS:Twenty-eight women undergoing radical hysterectomy for cervical cancer stage IB had HPV DNA testing in cervical tissue, plasma, and the la...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/LGT.0b013e31818c66e6

    authors: Peedicayil A,Sathish N,Gnanamony M,John S,Viswanathan FR,Naseema PS,Abraham P

    更新日期:2009-04-01 00:00:00

  • Vulvar intraepithelial neoplasia: a synopsis of recent developments.

    abstract::This review highlights recent advances in our understanding of preneoplastic squamous lesions of the vulva, from a pathologist's perspective. Vulvar intraepithelial neoplasia (VIN) is the preferred nomenclature for these lesions. VIN lesions may or may not be symptomatic and have a variable clinical appearance. Three ...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/00128360-199801000-00007

    authors: Colgan TJ

    更新日期:1998-01-01 00:00:00

  • Human papillomavirus prevalence in invasive anal cancers in the United States before vaccine introduction.

    abstract:OBJECTIVE:This study aimed to conduct a representative survey of human papillomavirus (HPV) prevalence and its genotype distribution in invasive anal cancer specimens in the United States. MATERIALS AND METHODS:Population-based archival anal cancer specimens were identified from Florida, Kentucky, Louisiana, and Michi...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/LGT.0b013e31827ed372

    authors: Steinau M,Unger ER,Hernandez BY,Goodman MT,Copeland G,Hopenhayn C,Cozen W,Saber MS,Huang Y,Peters ES,Lynch CF,Wilkinson EJ,Rajeevan MS,Lyu C,Saraiya M

    更新日期:2013-10-01 00:00:00

  • Cervical intraepithelial neoplasia 2, 3 in pregnancy: time to consider loop cone excision in the first trimester of pregnancy?

    abstract:OBJECTIVES:To report the outcome of patients diagnosed with cervical intraepithelial neoplasia 2, 3 (CIN 2, 3) during pregnancy, who were treated by large loop excision of the transformation zone (LLETZ) in the first trimester or were followed up conservatively and treated after delivery. METHODS:Patients diagnosed wi...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/LGT.0b013e318299c0af

    authors: Siegler E,Amit A,Lavie O,Auslender R,Mackuli L,Weissman A

    更新日期:2014-04-01 00:00:00

  • Vulvovaginal candidiasis in postmenopausal women: the role of hormone replacement therapy.

    abstract:OBJECTIVE:: This study aimed to explore the role of hormone replacement therapy (HRT) in susceptibility to vulvovaginal candidiasis (VVC) in a private vulval disease referral practice. METHODS:: Between January 2009 and December 2010, 149 healthy, nondiabetic patients with vulvar conditions were compared for significa...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/LGT.0b013e3182241f1a

    authors: Fischer G,Bradford J

    更新日期:2011-10-01 00:00:00

  • Mesenchymal lesions of the vulva.

    abstract::Mesenchymal lesions of the vulva may be either regionally specific to the vulva or soft tissue neoplasms that can occur in multiple locations on the body. They may have overlapping histological and immunohistochemical features and, in routine practice, are not likely to be encountered, adding to the diagnostic difficu...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章,评审

    doi:10.1097/LGT.0b013e3181f6f2d0

    authors: Fitzhugh VA,Heller DS

    更新日期:2011-04-01 00:00:00

  • Assessment of Anal Cancer Screening Tools in Detecting High-Grade Anal Squamous Intraepithelial Lesions in Women.

    abstract:OBJECTIVE:The aim of the study was to evaluate the validity of anal cytology against high-resolution anoscopy in the detection of anal high-grade squamous intraepithelial lesions (HSILs) among women in a clinical setting in Puerto Rico, alone and in combination with high-risk human papillomavirus (HR-HPV) typing. MATE...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/LGT.0000000000000497

    authors: Ramos-Cartagena JM,Pérez CM,Guiot HM,Amaya-Ardilla CP,Tirado-Gómez M,Ortiz AP

    更新日期:2020-01-01 00:00:00

  • Clinical significance of cervical smears with atypical squamous cells of undetermined significance designated "favor reactive" or "favor preneoplastic".

    abstract:OBJECTIVE:Our aim was to determine the clinical significance of the two subgroups of atypical squamous cells of undetermined significance (ASCUS), designated "favor reactive" and "favor preneoplastic." MATERIALS AND METHODS:Cervical Papanicolaou smears with a diagnosis of ASCUS favor reactive or ASCUS favor preneoplas...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/00128360-199707000-00006

    authors: Yang M,Zachariah S

    更新日期:1997-07-01 00:00:00

  • Giant condyloma versus verrucous carcinoma: a case report.

    abstract::Giant condyloma acuminatum is a large, slow-growing, exophytic, cauliflower-like tumor of the external genitalia. It is a histologically benign lesion, largely associated with human papillomavirus infection but with a high recurrence rate. The main differential diagnosis includes verrucous carcinoma. Differentiation b...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/LGT.0b013e3181c945ed

    authors: Bambao C,Nofech-Mozes S,Shier M

    更新日期:2010-07-01 00:00:00

  • Key Determinants of the Value of Random Cervical Biopsy at Colposcopy.

    abstract:OBJECTIVE:The aim of the study was to assess whether lower proportions of cervical intraepithelial neoplasia 2+ diagnosed by random biopsy are from lower cut points defining an abnormal colposcopic impression or obtaining only one random biopsy when colposcopic impression is normal. METHODS:We compared colposcopy expe...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/LGT.0000000000000485

    authors: Pretorius RG,Belinson JL,Burchette RJ,Wu R,Qiao YL

    更新日期:2019-10-01 00:00:00

  • Lichen sclerosus: treatment and follow-up at the departments of gynaecology and dermatology.

    abstract:OBJECTIVE:To compare the treatment and follow-up of patients with lichen sclerosus (LS) at the departments of Gynaecology and Dermatology at the Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands, to evaluate the need for a multidisciplinary vulvar clinic. MATERIALS AND METHODS:Treatment and follow-...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/LGT.0b013e3181c4bfe6

    authors: van der Avoort IA,Tiemes DE,van Rossum MM,van der Vleuten CJ,Massuger LF,de Hullu JA

    更新日期:2010-04-01 00:00:00

  • Cervical Cancer Screening of Adolescents Should Not Be Encouraged.

    abstract:OBJECTIVE:The study aims to assess the frequency of cytological abnormalities in adolescents and young women, to establish the optimum age to start screening. METHODS:A retrospective study of cervical cytology results were obtained from the data center at the Santa Casa Hospital of São Paulo between January 2006 and D...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/LGT.0000000000000273

    authors: Henrique LQ,Campaner AB,dʼAvila FS

    更新日期:2017-01-01 00:00:00

  • Long-term surveillance is required for all women treated for cervical adenocarcinoma in situ.

    abstract:OBJECTIVE:To measure the recurrence rate of disease in women treated for cervical adenocarcinoma in situ (ACIS) by either hysterectomy or conservative surgical management. PATIENTS AND METHODS:One hundred patients with a histopathologic diagnosis of ACIS or glandular dysplasia were identified in a retrospective clinic...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/00128360-200404000-00008

    authors: Hwang DM,Lickrish GM,Chapman W,Colgan TJ

    更新日期:2004-04-01 00:00:00

  • The vaginal vestibule.

    abstract:OBJECTIVES:Vulvar vestibule is a common term in the medical nomenclature. In our view, this term is inaccurate. MATERIALS AND METHODS:Herein, we provide evidence from embryologic, anatomic, and architectonic textbooks that shows the links between the vestibule and vagina. RESULTS:Our research proves that the term vul...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/00128360-200401000-00014

    authors: Friedman M,Siegler E,Löwenstein L

    更新日期:2004-01-01 00:00:00

  • Recommendations and administration of the HPV vaccine to 11- to 12-year-old girls and boys: a statewide survey of Georgia vaccines for children provider practices.

    abstract:OBJECTIVE:This study explores the prevalence and provider- and practice-related correlates of physician recommendation and administration of the quadrivalent human papillomavirus (HPV) vaccine, Gardasil, to 11- to 12-year-old girls and the intention to recommend the HPV vaccine to 11- to 12-year-old boys in Georgia. Th...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/LGT.0000000000000011

    authors: Luque JS,Tarasenko YN,Dixon BT,Vogel RL,Tedders SH

    更新日期:2014-10-01 00:00:00

  • A Cross-Sectional Review of Cervical Cancer Messages on Twitter During Cervical Cancer Awareness Month.

    abstract:OBJECTIVES:The objectives of this study were to quantify personal stories about cervical cancer and to determine the proportion and sentiment (positive vs negative) of messages ("tweets") that discussed cervical cancer prevention strategies on Twitter. METHODS:This study was a cross-sectional Twitter review of English...

    journal_title:Journal of lower genital tract disease

    pub_type: 杂志文章

    doi:10.1097/LGT.0000000000000363

    authors: Teoh D,Shaikh R,Vogel RI,Zoellner T,Carson L,Kulasingam S,Lou E

    更新日期:2018-01-01 00:00:00