(please see table 1)
Table 2 further separates discordant referrals by age group. For
patients between 21 and 24 years of age, there were 31 (41%) discordant
referrals. Of which 6 (19%) had pap-test results indicating ASCUS, 24
(77%) had LSIL results, and 1 (0.3%) had a NILM pap-test result. For
discordant referrals in this age range there were significant
differences for HPV results among the cervical cytology categories
however, there were not any statistically significant differences in
other variables.
In the 25 to 29 age range, there were 5 discordant referrals, one with a
pap-test result of ASCUS and the other 4 with NILM pap-test result.
There were 39 (52%) patients in the 30 to 64 age range with discordant
referrals with 38% with ASCUS results, 31% with LSIL results, 5% with
HSIL results, and 26% with NILM pap-test results.
Not included in the table, of the discordant LSIL in patients age 21 to
24, seven went on to receive non-indicated colposcopies at VCU.
Furthermore, two of these patients underwent a LEEP procedure as the
colposcopy for LSIL at age 21 to 24 resulted CIN II or CIN III. The most
common discordance in regards to ASCUS referrals was when the co-testing
of high-risk HPV subtypes was negative (n = 7). Seven women age 21 to 24
with ASCUS cytology and positive HPV were referred for colposcopy
instead of repeat cytology in one year. Additionally, seven referrals
for ASCUS cytology did not have any co-testing or reflex testing.
In addition to the mentioned findings, ten patients were referred for
cervical cytology collected on vaginal cuffs despite prior
hysterectomies performed for benign reasons. Two of these had findings
of HSIL. Additionally, seven patients were referred with the first
occurrence of HPV+ screening with NILM cytology instead of having
co-testing in twelve months.