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- Title
Reporting benign endometrial cells (BECS) on Pap smears in the light of the Bethesda 2014 recommendations.
- Authors
Haddad, Maha; Cormier, Karen; Fischer, Gabor
- Abstract
Objectives: The cut-off age of reporting BECs on Pap smears was changed from >40 to >45 years in the 2014 Bethesda system, however there is no consensus on the optimal age for reporting. We designed the study to determine the ideal age for reporting BECs to provide the best patient management. Materials and methods: Pap smears with BECs for women >40 years were retrieved from DSM's laboratory information system registered from October 1st, 2012 to October 30th, 2015. Age and date of last menstrual period (LMP) was recorded. Follow up diagnoses were categorized as malignant, premalignant (all hyperplasias + atypia) and normal/other benign pathology. The Fischer's exact test was used to assess the association between categorical variables, P<0.05 (two-sided test) was considered significant. Results: The search identified 352 cases with benign endometrial cells, 155 had surgical follow up. On histology follow-up no malignancy was present in women 40-49 years of age compared to 5 malignancies in women 50+ years (P=0.016). In women 40-49 years of age, the combined number of cases with hyperplasia and malignancies was 4, compared to 11 in women 50+ years (P=0.029). The last menstrual period was inconsistently provided (57%), however all malignancies and half of the hyperplasias were diagnosed in women identified postmenopausal on the requisition. Conclusions: Increasing the reporting age for BECs to >50 would lead to more optimal patient management. Reporting BECs in postmenopausal women may be a reasonable alternative, but that would require consistent recording of the LMP on the requisitions.
- Publication
Canadian Journal of Pathology, 2016, Vol 8, p43
- ISSN
1918-915X
- Publication type
Article