Risk of CIN2+ in women aged >60 years with abnormal cervical cancer screening: a multicenter retrospective cohort study from the Thai Gynecologic Cancer Society research group
1
Issued Date
2025-09-01
Resource Type
eISSN
20050399
Scopus ID
2-s2.0-105015685485
Pubmed ID
40275682
Journal Title
Journal of Gynecologic Oncology
Volume
36
Issue
5
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Gynecologic Oncology Vol.36 No.5 (2025) , e83
Suggested Citation
Jareemit N., Kolaka W., Tiyayon J., Tangjitgamol S., Inthasorn P., Kittikhun R., Kantathavorn N. Risk of CIN2+ in women aged >60 years with abnormal cervical cancer screening: a multicenter retrospective cohort study from the Thai Gynecologic Cancer Society research group. Journal of Gynecologic Oncology Vol.36 No.5 (2025) , e83. doi:10.3802/jgo.2025.36.e83 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/112142
Title
Risk of CIN2+ in women aged >60 years with abnormal cervical cancer screening: a multicenter retrospective cohort study from the Thai Gynecologic Cancer Society research group
Corresponding Author(s)
Other Contributor(s)
Abstract
OBJECTIVE: To study patterns of abnormal cervical cancer screening in women aged >60 years and explore the risk and predictors of cervical intraepithelial neoplasia grade 2 or worse (CIN2+). METHODS: This retrospective cohort study examined 1,596 women aged >60 years with abnormal cervical cancer screening results from eight Thai cancer centers. Those who underwent hysterectomy were excluded. Patient characteristics, previous and current cervical cancer screening results, and histopathology data were collected and analyzed. RESULTS: Mean age was 68.2±7.2 years. The abnormal screening results were normal cytology with positive high-risk human papillomavirus (0.9%), atypical squamous cells of undetermined significance (37.7%), low-grade squamous intraepithelial lesion (12%), atypical squamous cell cannot exclude high-grade lesion (11.7%), high-grade squamous intraepithelial lesion (12.7%), atypical glandular cell (20.1%), squamous cell carcinoma (4.3%), and adenocarcinoma (0.7%). Risk of CIN2+ in women with abnormal screening was 17.9% (95% confidence interval [CI]=16.1-19.8); among those with available histopathology, the risk was 28.8% (95% CI=26.1-31.7). Univariable logistic regression showed that age >70 years, sexual activity within 1 year, previous abnormal/no screening, previous CIN2+ pathology, presence of symptoms, and high-grade cytology were significant predictors of CIN2+. In the multivariable analysis, lack of previous screening (adjusted odds ratio=4.05; 95% CI=1.91-8.60; p<0.001) and high-grade cytology (adjusted odds ratio=7.00; 95% CI=3.34-14.67; p<0.001) were independent predictors of CIN2+. CONCLUSION: Continuing cervical cancer screening in women aged >60 years should be individualized based on their risk factors, particularly for those who have never been screened.