Predictors of abnormal cervical cytology in a college population

2.50
Hdl Handle:
http://hdl.handle.net/10755/148479
Type:
Presentation
Title:
Predictors of abnormal cervical cytology in a college population
Abstract:
Predictors of abnormal cervical cytology in a college population
Conference Sponsor:Sigma Theta Tau International
Conference Year:1991
Author:Schaffer, Susan, MS/MSc
P.I. Institution Name:Old Dominion UniversitySchool of Nursing
Title:Assistant Professor
Cervical cytology screening has been an integral part of women's

preventive health care since 1943. Current research implicating

human papillomavirus (HPV) as the etiological agent in cervical

cancer as well as studies suggesting an increase in the incidence

and rate of progression of cervical cytology (pap smear)

abnormalities have generated debate over the frequency of screening

and the role of risk factors such as smoking and other STDS.



A retrospective record review was undertaken for pap smears done

from 1978-1989 at a large urban southeastern university. The

research questions for this exploratory study were: Has the

incidence of abnormal cervical cytology changed in this population

over the study period? Can abnormal cervical cytology be predicted

through analysis of reported risk factors?



Of 6,224 cervical smears collected during the study period, 2,180

(34.9 percent) were reported to be abnormal. Analysis of variance

and Duncan's multiple range test revealed a significant increase in

mean severity of abnormal smears over the study period (p=.0001,

df=10, 4173). The peak year for abnormal cervical cytology (1987)

coincided with the peak year for HPV infection.



In a stepwise regression, three of the independent variables (risk

factors) were entered into the equation, accounting for 10.5

percent of the variance. These were current HPV infection (8

percent, p=.0001), year in which pap was taken, (2 percent,

p=.002), and current herpes (.5 percent, NS). If HPV is indeed

responsible for the majority of cervical abnormalities, the

infection is not reliably detected through routine examination and

cervical cytology screening.



Analysis of variance and Duncan's test were utilized to examine the

mean cervical cytology severity of women who had evidence of HPV

alone, those who had HPV, herpes, and were smokers, and women who

had none of these risk factors. Mean cervical cytology between

groups was significantly different at .00001, df=2, 5821. This

demonstrates an apparent additive effect between these risk

factors. Women with all three risk factors had mean pap severity

scores reflecting squamous atypias.



Actively expressed HPV and herpes at the time of a pap smear

represent significant predictors for abnormal pap smears. Women

who smoke experience additional risk. HPV DNA hybridization

screening may facilitate the identification of women at high risk

for cervical abnormalities, but the predictive value of this test

has not been demonstrated. An increased frequency of pap screening

in sexually active populations may be a cost effective way to

detect early cervical abnormalities.



Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePredictors of abnormal cervical cytology in a college populationen_GB
dc.identifier.urihttp://hdl.handle.net/10755/148479-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Predictors of abnormal cervical cytology in a college population</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1991</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Schaffer, Susan, MS/MSc</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Old Dominion UniversitySchool of Nursing</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr><td colspan="2" class="item-abstract">Cervical cytology screening has been an integral part of women's<br/><br/>preventive health care since 1943. Current research implicating<br/><br/>human papillomavirus (HPV) as the etiological agent in cervical<br/><br/>cancer as well as studies suggesting an increase in the incidence<br/><br/>and rate of progression of cervical cytology (pap smear)<br/><br/>abnormalities have generated debate over the frequency of screening<br/><br/>and the role of risk factors such as smoking and other STDS.<br/><br/><br/><br/>A retrospective record review was undertaken for pap smears done<br/><br/>from 1978-1989 at a large urban southeastern university. The<br/><br/>research questions for this exploratory study were: Has the<br/><br/>incidence of abnormal cervical cytology changed in this population<br/><br/>over the study period? Can abnormal cervical cytology be predicted<br/><br/>through analysis of reported risk factors?<br/><br/><br/><br/>Of 6,224 cervical smears collected during the study period, 2,180<br/><br/>(34.9 percent) were reported to be abnormal. Analysis of variance<br/><br/>and Duncan's multiple range test revealed a significant increase in<br/><br/>mean severity of abnormal smears over the study period (p=.0001,<br/><br/>df=10, 4173). The peak year for abnormal cervical cytology (1987)<br/><br/>coincided with the peak year for HPV infection.<br/><br/><br/><br/>In a stepwise regression, three of the independent variables (risk<br/><br/>factors) were entered into the equation, accounting for 10.5<br/><br/>percent of the variance. These were current HPV infection (8<br/><br/>percent, p=.0001), year in which pap was taken, (2 percent,<br/><br/>p=.002), and current herpes (.5 percent, NS). If HPV is indeed<br/><br/>responsible for the majority of cervical abnormalities, the<br/><br/>infection is not reliably detected through routine examination and<br/><br/>cervical cytology screening.<br/><br/><br/><br/>Analysis of variance and Duncan's test were utilized to examine the<br/><br/>mean cervical cytology severity of women who had evidence of HPV<br/><br/>alone, those who had HPV, herpes, and were smokers, and women who<br/><br/>had none of these risk factors. Mean cervical cytology between<br/><br/>groups was significantly different at .00001, df=2, 5821. This<br/><br/>demonstrates an apparent additive effect between these risk<br/><br/>factors. Women with all three risk factors had mean pap severity<br/><br/>scores reflecting squamous atypias.<br/><br/><br/><br/>Actively expressed HPV and herpes at the time of a pap smear<br/><br/>represent significant predictors for abnormal pap smears. Women<br/><br/>who smoke experience additional risk. HPV DNA hybridization<br/><br/>screening may facilitate the identification of women at high risk<br/><br/>for cervical abnormalities, but the predictive value of this test<br/><br/>has not been demonstrated. An increased frequency of pap screening<br/><br/>in sexually active populations may be a cost effective way to<br/><br/>detect early cervical abnormalities.<br/><br/><br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T09:45:46Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T09:45:46Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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