{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T04:39:43Z","timestamp":1771907983335,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2013,2,28]],"date-time":"2013-02-28T00:00:00Z","timestamp":1362009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>The current American College of Obstetricians and Gynecologists guidelines state that cervical cancer screening should begin at age 21 years, regardless of sexual or obstetric history. However, previous studies have demonstrated that there is a small but significant subset of high\u2010risk adolescents with extensive sexual and obstetric history who harbor a significant squamous cervical lesion. The objective of the current study was to use histologic and demographic data from adolescents (aged &lt;21 years) who received Papanicolaou (Pap) tests to determine whether they benefited from early cervical cancer screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Adolescent girls who had Pap tests between 2000 and 2010 were included in the study. Demographic data, including obstetric history, number of sexual partners, age of first coitus, age at first pregnancy, menarche, smoking history, and Chlamydia and syphilis infection, were analyzed for associations with levels of cervical dysplasia.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Of 56,785 adolescent Pap tests, 277 (0.5%) were diagnosed as high\u2010grade squamous HSIL, and 56 of those Pap tests (20%) were from patients who had grade 3 cervical intraepithelial neoplasia (CIN\u20103) on subsequent biopsy and\/or excision. One patient had microinvasive cervical carcinoma identified on loop electrosurgical excision procedure at age 27 years after an HSIL Pap test. Increased parity was associated significantly with higher rates of CIN\u20103.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The study findings indicated that current American College of Obstetricians and Gynecologists guidelines to begin Pap testing at age 21 years are appropriate for the majority of adolescents, because the rate of HSIL is very low, and the risk for invasive carcinoma is minimal. Although higher parity was associated with a significantly increased grade of CIN, the conclusions are questionable because of the significant amount of missing demographic data points. That being said, this study should lead to other similar studies to determine any association of higher grade CIN with adolescent sexual and obstetric history. <jats:bold><jats:italic>Cancer (Cancer Cytopathol)<\/jats:italic> 2013;121:432\u20139.<\/jats:bold> \u00a9 <jats:italic>2013 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.21274","type":"journal-article","created":{"date-parts":[[2013,3,1]],"date-time":"2013-03-01T05:15:00Z","timestamp":1362114900000},"page":"432-439","source":"Crossref","is-referenced-by-count":6,"title":["Should high\u2010risk adolescents have Papanicolaou tests?"],"prefix":"10.1002","volume":"121","author":[{"given":"Ly T.","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Pathology Division of Cytopathology University of Texas Medical Branch Galveston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerald A.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Pathology Division of Cytopathology University of Texas Medical Branch Galveston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gwyn","family":"Richardson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology\/Oncology University of Texas Medical Branch Galveston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vicki J.","family":"Schnadig","sequence":"additional","affiliation":[{"name":"Department of Pathology Division of Cytopathology University of Texas Medical Branch Galveston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,2,28]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181eeb30f"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0b013e3181cec411"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181c6f8a4"},{"key":"e_1_2_7_5_1","first-page":"147","article-title":"Update on ASCCP consensus guidelines for abnormal cervical screening tests and cervical histology","volume":"80","author":"Apgar BS","year":"2009","journal-title":"Am Fam Physician"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-009-9317-z"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68181-6"},{"key":"e_1_2_7_8_1","doi-asserted-by":"crossref","first-page":"361","DOI":"10.5858\/2010-0121-OA.1","article-title":"Follow\u2010up findings in young females with high\u2010grade squamous intraepithelial lesion Papanicolaou test results","volume":"135","author":"Zhao C","year":"2011","journal-title":"Arch Pathol Lab Med"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.09.008"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.3322\/canjclin.57.1.7"},{"issue":"2","key":"e_1_2_7_11_1","first-page":"1","article-title":"Quadrivalent human papillomavirus vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"56","author":"Markowitz LE","year":"2007","journal-title":"MMWR Recomm Rep"},{"key":"e_1_2_7_12_1","first-page":"1117","article-title":"National and state vaccination coverage among adolescents aged 13 through 17 years\u2014United States, 2010","volume":"60","author":"Centers for Disease Control and Prevention (CDC)","year":"2011","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.4103\/1742-6413.81773"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23758"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000165822.29451.54"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2012.148"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1756-0500-5-149"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djn099"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31818c9222"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-0976.2001.53004.x"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.461"},{"key":"e_1_2_7_22_1","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1093\/jnci\/93.4.293","article-title":"Comparison of 3 management strategies for patients with atypical squamous cells of undetermined significance: baseline results from a randomized trial. 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