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“Inadequate” cervical smears may be associated with increased risk of subsequent cancer
August 01, 2003Poor quality cervical smears may be associated with an increased risk of subsequent cancer, suggests a study in the Journal of Clinical Pathology.
Despite the successes of the cervical cancer screening programme, with an annual drop of 7% in deaths from the disease, inadequate smears comprise a substantial proportion of all smears taken, say the authors, and are higher in the UK than elsewhere.
They assessed the quality of over 25,000 smear tests taken between April 1995 and March 1996 at one Midlands hospital. Smears were deemed to be “inadequate” if there were too few cells, more than half the tissue was obscured by blood, inflammatory cells, or bacteria, the cells were spread too thickly, or the fixing solution was insufficient. More than one reason was given for the poor quality of the smear in around 15%.
Just under 2000 women (8%) had a poor quality smear, a figure that is within the national range. Excluding almost 200 women, the rest were monitored for five years to detect any cellular changes on subsequent smears. Their average age was 37.
In all, 256 women (13%) developed abnormalities during the five years of monitoring, of whom almost one in 10 (185) had no evidence of abnormality on further assessment. Of the remainder, 71 (3.6%) had developed cellular abnormalities. Of these 32, had low grade (minor) changes and 39 had high grade (serious) changes.
Although the overall percentages were small, the risk of developing high grade changes five years later was almost twice as high among women with poor quality smears as it was among all the women screened.
The association between a poor quality smear and the development of serious cancerous changes was greatest in those smears for which several reasons were given for the inadequacy of the sample. And within this group, smears obscured by inflammatory cells carried the greatest risk, with high grade changes developing in over 3%. Inflammatory cells were present in almost one in four poor quality smears.
The authors emphasise that the increased risk found in their study was not statistically significant. But they say that had a larger number of women been studied, this might have been different, and they call for more studies to explore this.
British Medical Journal (BMJ)
Just under 2000 women (8%) had a poor quality smear, a figure that is within the national range. Excluding almost 200 women, the rest were monitored for five years to detect any cellular changes on subsequent smears. Their average age was 37.
In all, 256 women (13%) developed abnormalities during the five years of monitoring, of whom almost one in 10 (185) had no evidence of abnormality on further assessment. Of the remainder, 71 (3.6%) had developed cellular abnormalities. Of these 32, had low grade (minor) changes and 39 had high grade (serious) changes.
Although the overall percentages were small, the risk of developing high grade changes five years later was almost twice as high among women with poor quality smears as it was among all the women screened.
The association between a poor quality smear and the development of serious cancerous changes was greatest in those smears for which several reasons were given for the inadequacy of the sample. And within this group, smears obscured by inflammatory cells carried the greatest risk, with high grade changes developing in over 3%. Inflammatory cells were present in almost one in four poor quality smears.
The authors emphasise that the increased risk found in their study was not statistically significant. But they say that had a larger number of women been studied, this might have been different, and they call for more studies to explore this.
British Medical Journal (BMJ)
Cancer Current Events and Cancer News RSSMetabolic reactions: Less is more in single-celled organisms
A Northwestern University study has found a surprising similarity among four quite different organisms. The simplest organism, a bacterium called H. pylori, uses the same number of biochemical reactions (around 300) as yeast, the largest, most complex organism of the group, when optimizing growth.
Crystallography reveals the 3-D structure of mammalian sperm receptor
Scientists at the Swedish medical university Karolinska Institutet have determined the first 3D structure of ZP3, a protein essential for the interaction between the mammalian egg coat and sperm.
Dormant stem cells for emergencies
Many specialized cells, such as in the skin, intestinal mucosa or blood, have a lifespan of only a few days. For these tissues to function, a steady replenishment of specialized cells is indispensable. This is the task of so-called "adult" stem cells also known as tissue stem cells.
Bone marrow-derived stem cells may offer novel therapeutic option for skin disorder
Stem cells derived from bone marrow may serve as a novel therapeutic option to treat a disease called epidermolysis bullosa (EB), a disorder characterized by extraordinarily fragile skin, according to a study prepublished online in Blood, the official journal of the American Society of Hematology.
Genetic breakdown in Fanconi anemia may have link to HPV-associated cancer
A genetic malfunction that causes DNA instability in people with the blood disorder Fanconi anemia may put them at high risk for squamous cell carcinomas linked to human papillomavirus (HPV), according to a study posted online ahead of print by Oncogene.
International study supports new standard of treatment for women with advanced ovarian cancer
Results of a phase III, international randomized clinical trial demonstrate a new standard of care for treating advanced ovarian cancer that significantly reduces side-effects and post-operative deaths compared to the previously established treatment course.
Researchers identify cell group key to Lyme disease arthritis
A research team led by the La Jolla Institute for Allergy & Immunology and Albany Medical College has illuminated the important role of natural killer (NK) T cells in Lyme disease, demonstrating that the once little understood white blood cells are central to clearing the bacterial infection and reducing the intensity and duration of arthritis associated with Lyme disease.
Researchers Discover New Enzyme in Cancer Growth
While studying the mechanics of blood clots, researchers at the University of Oklahoma Health Sciences Center discovered a new enzyme that not only affects the blood, but seems to play a primary role in how cancer tumors expand and spread throughout the body.
Angled gantry technique reduced breast radiation exposure by 50 percent
A novel angled gantry approach to coronary CT angiography reduced radiation exposure to the breast by more than 50%, according to Thomas Jefferson University researchers.
HER2 levels may aid in treatment selection for metastatic breast cancer
Findings published in the December 1, 2008, issue of Clinical Cancer Research, a journal of the American Association for Cancer Research, show lapatinib benefits women with HER2-positive breast cancer, while women with HER2-negative breast cancer or those who express EGRF alone derive no incremental benefit.
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