Incidence of cytological abnormalities within 24 months of a normal cervical smear in Soweto, South Africa

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dc.contributor.authorAdam, Yasmin
dc.contributor.authorMcIntyre, James Alasdair
dc.contributor.authorde Bruyn, Guy
dc.date.accessioned2021-10-08T07:17:59Z
dc.date.available2021-10-08T07:17:59Z
dc.date.issued2012
dc.description.abstractBACKGROUND: A screening programme for cervical cancer has been implemented in South Africa (SA) with intervals of 10 years after a normal cytological result. There are no studies that evaluate repeat screening at a shorter interval in SA. OBJECTIVES: (i) To find the incidence of cytological abnormalities on a repeat test after a report of normal cytology or an inadequate Pap smear; and (ii) to explore the factors associated with an abnormal cytology on repeat testing. METHODS: This was a secondary data analysis of a randomised controlled trial of diaphragm, lubricant gel and condoms v. condoms in the prevention of HIV infection. HIV-negative women were recruited between November 2003 and December 2005, with a normal Pap smear at entry. Observation time was from the first Pap smear to the date of the repeat Pap smear. Explanatory variables used were baseline, excepting any new HIV infection. RESULTS: The incidence of cytological abnormalities was 6.48% yearly in women with a previously normal Pap smear and 11.71% yearly in women with an inadequate smear result (p=0.03). The incidence of high-grade squamous intra-epithelial lesions (HSILs) was <0.5%. Factors associated with abnormal cytology were a history of ectopic pregnancy (odds ratio (OR) 9.25; confidence interval (CI) 1.78 - 48.02; p=0.01), number of male partners (OR 1.12; CI 1.03 - 1.22; p=0.01), history of vaginal discharge (OR 13.95; CI 1.18 - 164.47; p=0.04), and incident HIV infection (OR 6.56; CI 1.14 - 38.16; p=0.04). CONCLUSION: The incidence of HSILs is low in the first 2 years after a normal or inadequate Pap smear, even in a setting with a high prevalence of cytological abnormalities.
dc.identifier.apacitationAdam, Y., McIntyre, J. A., & de Bruyn, G. (2012). Incidence of cytological abnormalities within 24 months of a normal cervical smear in Soweto, South Africa. <i>South African Medical Journal</i>, 103(1), 34 - 177. http://hdl.handle.net/11427/34878en_ZA
dc.identifier.chicagocitationAdam, Yasmin, James Alasdair McIntyre, and Guy de Bruyn "Incidence of cytological abnormalities within 24 months of a normal cervical smear in Soweto, South Africa." <i>South African Medical Journal</i> 103, 1. (2012): 34 - 177. http://hdl.handle.net/11427/34878en_ZA
dc.identifier.citationAdam, Y., McIntyre, J.A. & de Bruyn, G. 2012. Incidence of cytological abnormalities within 24 months of a normal cervical smear in Soweto, South Africa. <i>South African Medical Journal.</i> 103(1):34 - 177. http://hdl.handle.net/11427/34878en_ZA
dc.identifier.issn0038-2469
dc.identifier.ris TY - Journal Article AU - Adam, Yasmin AU - McIntyre, James Alasdair AU - de Bruyn, Guy AB - BACKGROUND: A screening programme for cervical cancer has been implemented in South Africa (SA) with intervals of 10 years after a normal cytological result. There are no studies that evaluate repeat screening at a shorter interval in SA. OBJECTIVES: (i) To find the incidence of cytological abnormalities on a repeat test after a report of normal cytology or an inadequate Pap smear; and (ii) to explore the factors associated with an abnormal cytology on repeat testing. METHODS: This was a secondary data analysis of a randomised controlled trial of diaphragm, lubricant gel and condoms v. condoms in the prevention of HIV infection. HIV-negative women were recruited between November 2003 and December 2005, with a normal Pap smear at entry. Observation time was from the first Pap smear to the date of the repeat Pap smear. Explanatory variables used were baseline, excepting any new HIV infection. RESULTS: The incidence of cytological abnormalities was 6.48% yearly in women with a previously normal Pap smear and 11.71% yearly in women with an inadequate smear result (p=0.03). The incidence of high-grade squamous intra-epithelial lesions (HSILs) was <0.5%. Factors associated with abnormal cytology were a history of ectopic pregnancy (odds ratio (OR) 9.25; confidence interval (CI) 1.78 - 48.02; p=0.01), number of male partners (OR 1.12; CI 1.03 - 1.22; p=0.01), history of vaginal discharge (OR 13.95; CI 1.18 - 164.47; p=0.04), and incident HIV infection (OR 6.56; CI 1.14 - 38.16; p=0.04). CONCLUSION: The incidence of HSILs is low in the first 2 years after a normal or inadequate Pap smear, even in a setting with a high prevalence of cytological abnormalities. DA - 2012 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - South African Medical Journal LK - https://open.uct.ac.za PY - 2012 SM - 0038-2469 T1 - Incidence of cytological abnormalities within 24 months of a normal cervical smear in Soweto, South Africa TI - Incidence of cytological abnormalities within 24 months of a normal cervical smear in Soweto, South Africa UR - http://hdl.handle.net/11427/34878 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34878
dc.identifier.vancouvercitationAdam Y, McIntyre JA, de Bruyn G. Incidence of cytological abnormalities within 24 months of a normal cervical smear in Soweto, South Africa. South African Medical Journal. 2012;103(1):34 - 177. http://hdl.handle.net/11427/34878.en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Public Health and Family Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.sourceSouth African Medical Journal
dc.source.journalissue1
dc.source.journalvolume103
dc.source.pagination34 - 177
dc.source.urihttps://dx.doi.org/10.7196/SAMJ.6124
dc.subject.otherVaginal Discharge
dc.subject.otherHIV Infections
dc.subject.otherUterine Cervical Neoplasms
dc.subject.otherPregnancy, Ectopic
dc.subject.otherDiaphragm
dc.subject.otherLubricants
dc.subject.otherGels
dc.subject.otherPapanicolaou Test
dc.subject.otherVaginal Smears
dc.subject.otherPrevalence
dc.subject.otherIncidence
dc.subject.otherOdds Ratio
dc.subject.otherStatistics as Topic
dc.subject.otherConfidence Intervals
dc.subject.otherCondoms
dc.subject.otherHuman immunodeficiency virus 1
dc.subject.otherHomo sapiens
dc.subject.otherCervical cancer precursors
dc.subject.otherPap smears
dc.subject.otherScreening
dc.subject.otherSouth Africa
dc.titleIncidence of cytological abnormalities within 24 months of a normal cervical smear in Soweto, South Africa
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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