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OBJECTIVE The aim of this study was to determine the sensitivity of cytopathologic examination for the detection of vaginal or cervical clear cell adenocarcinoma (CCA). METHODS Systematic collection in the Dutch automated nationwide pathology archive of all cytology and histology data of women with CCA, born in The Netherlands after 1947 was performed. All cytologic examinations within 2 years prior to histological diagnosis of CCA were included. RESULTS Ninety patients with CCA have been registered. Forty-nine of these patients had cytologic examinations prior to histology. Eighty-five percent of cervical CCAs were preceded by a positive cervical smear. One hundred percent of vaginal CCAs were preceded by a positive vaginal smear. Cervical smears are relatively insensitive to detect vaginal CCA. Vaginal smears were often omitted. Only 2 apparently false-negative smears were found. The mean numbers of smears in diethylstilbestrol (DES)-exposed and nonexposed women were minimally different: 1.0 and 0.8, respectively. This suggests an only modest impact of the awareness of DES as a risk factor. FIGO tumor stage I was preceded more frequently by cytology than the higher tumor stages. CONCLUSIONS The majority of CCA cases can be detected at an early stage by yearly clinical and cytological examinations, which must comprise cervical as well as vaginal sampling. Since CCA may also occur in postmenopausal women, for the purpose of secondary prevention of CCA regular cytologic examinations of DES-exposed women must be continued after menopause.
A G Hanselaar, and
E A Boss, and
L F Massuger, and
J L Bernheim
November 1979,
Obstetrical & gynecological survey,
A G Hanselaar, and
E A Boss, and
L F Massuger, and
J L Bernheim
February 1976,
American journal of obstetrics and gynecology,
A G Hanselaar, and
E A Boss, and
L F Massuger, and
J L Bernheim
January 1978,
Acta cytologica,
A G Hanselaar, and
E A Boss, and
L F Massuger, and
J L Bernheim
July 1982,
Journal of the National Medical Association,
A G Hanselaar, and
E A Boss, and
L F Massuger, and
J L Bernheim
September 1989,
Gynecologic oncology,
A G Hanselaar, and
E A Boss, and
L F Massuger, and
J L Bernheim
January 1990,
Seminars in surgical oncology,
A G Hanselaar, and
E A Boss, and
L F Massuger, and
J L Bernheim
July 1975,
The Journal of reproductive medicine,
A G Hanselaar, and
E A Boss, and
L F Massuger, and
J L Bernheim
May 2018,
The New England journal of medicine,
A G Hanselaar, and
E A Boss, and
L F Massuger, and
J L Bernheim
June 1986,
Gynecologic oncology,
A G Hanselaar, and
E A Boss, and
L F Massuger, and
J L Bernheim
January 1988,
Journal of clinical epidemiology,
