Implications of inflammatory changes on cervical cytology

• Published in: BMJ Vol. 300; no. 6725; pp. 638 - 640
• Main Authors: Wilson, J D, Robinson, A J, Kinghorn, S A, Hicks, D A
• Format: Journal Article
• Language: English
• Published: London British Medical Journal Publishing Group 10-03-1990; British Medical Association; BMJ Publishing Group LTD
• Subjects: Adolescent; Adult; Age Factors; Biological and medical sciences; Cervix uteri; Cervix Uteri - pathology; Colposcopy; Contraception; Cytology; Family planning clinics; Female; General practice; Genitalia; Gynecology. Andrology. Obstetrics; Humans; Infections; Inflammation - pathology; Marriage; Medical sciences; Middle Aged; Prospective Studies; Risk Factors; Sexual Partners; Sexually transmitted diseases; Sexually Transmitted Diseases - diagnosis; Sexually Transmitted Diseases - etiology; Sexually Transmitted Diseases - pathology; Vaginal Smears; Human; Pathology; Pathophysiology; Uterine cervix; Genital diseases; Female genital diseases; Inflammatory disease
• ISSN: 0959-8138; 0959-8146; 1468-5833; 1756-1833
• DOI: 10.1136/bmj.300.6725.638

OBJECTIVE--To assess premenopausal women with inflammatory changes on cervical cytology for genital infections and cervical abnormalities. DESIGN--Prospective study of women attending general practice and family planning clinics who had a recent cervical cytology result with inflammatory changes. SETTING--Department of genitourinary medicine. PATIENTS--102 Premenopausal women with recent cytology result showing inflammatory changes and with no history of antibiotic or antifungal treatment since their smear. INVESTIGATIONS--Genital examination and microbiological screening for genital infections; colposcopic examination about six weeks later. MAIN OUTCOME MEASURES--Detection of genital infections, particularly those sexually acquired, and abnormalities on colposcopy. RESULTS--Genital infections were isolated in 77 patients, and one or more sexually acquired infections were found in 22. Prevalence of sexually acquired infections was significantly correlated with younger age (particularly being under 25), being single, separated, or divorced; using non-barrier contraception; and recent change of sexual partner. An abnormality on colposcopy was found in 36 women. There was a strong correlation of a sexually acquired infection with an abnormality at colposcopy; hence younger women were more likely to have a colposcopic abnormality. CONCLUSIONS--Inflammatory changes on cytology are often associated with the presence of a sexually acquired infection and premalignant disease of the cervix, particularly in younger, single women using non-barrier contraception.