Limited value for pap tests in endometrial cancer recurrence

(HealthDay)—For women who have undergone a hysterectomy for endometrial cancer, abnormal Papanicolaou (Pap) test results do not aid in diagnosing recurrent disease, according to a study published in the January issue of Obstetrics & Gynecology.

Akiva P. Novetsky, M.D., from the Washington University School of Medicine and Siteman Cancer Center in St. Louis, and colleagues analyzed data from 433 women who underwent a hysterectomy for endometrial cancer between 2006 and 2010 and had at least one postoperative Pap test, with a total of 2,378 Pap tests.

The researchers found that 13 percent of women had at least one abnormal cytology result, representing 3 percent of all Pap tests. On the basis of isolated abnormal cytology, no recurrent endometrial cancers were diagnosed. For women with atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion Pap test results, there were no cases of recurrent cancer diagnosed. Abnormal cytology was significantly associated with previous postoperative radiation therapy, in multivariable analysis. For detecting a local recurrence, the sensitivity, specificity, and positive and negative predictive values of an abnormal Pap test result were 40, 87.9, 7.3, and 98.4 percent, respectively.

"Our study supports previous studies demonstrating the significant limitation of Pap tests in diagnosing recurrent endometrial cancer," the authors write. "We found no cases of salvageable local recurrence diagnosed after abnormal cytology in the absence of patient symptoms or physical examination findings."

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