{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T18:52:24Z","timestamp":1757703144367},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,6,5]],"date-time":"2015-06-05T00:00:00Z","timestamp":1433462400000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>In 2006, Australia adopted a revised cervical cytology terminology system, known as the Australian Modified Bethesda System (<jats:styled-content style=\"fixed-case\">AMBS<\/jats:styled-content>). One substantial change in the <jats:styled-content style=\"fixed-case\">AMBS<\/jats:styled-content> was the introduction of the diagnostic category of atypical endocervical cells (<jats:styled-content style=\"fixed-case\">AEC<\/jats:styled-content>) of undetermined significance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this study was to investigate the incidence of histologically confirmed high\u2010grade cervical dysplasia (cervical intra\u2010epithelial neoplasia (<jats:styled-content style=\"fixed-case\">CIN<\/jats:styled-content>) grades 2 and 3 and adenocarcinoma <jats:italic>in\u00a0situ<\/jats:italic> (<jats:styled-content style=\"fixed-case\">ACIS<\/jats:styled-content>)), cervical carcinoma and endometrial carcinoma in women presenting with <jats:styled-content style=\"fixed-case\">AEC<\/jats:styled-content> on cervical cytology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A seven\u2010year retrospective study examining clinical outcomes of women with <jats:styled-content style=\"fixed-case\">AEC<\/jats:styled-content> on a screening cervical smear. Cytology and histology results were extracted from the Western Australia Cervical Screening Registry, and time\u2010to\u2010event analysis was used to predict the odds of having or developing <jats:italic>in\u00a0situ<\/jats:italic> and invasive neoplasia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">AEC<\/jats:styled-content> was reported in index smears from 0.093% (584\/622754) women during the study period. No follow\u2010up was available in 35 <jats:styled-content style=\"fixed-case\">AEC<\/jats:styled-content> cases. Sixty\u2010five of the remaining 549 women (11.8%) had, or developed, high\u2010grade cervical dysplasia within five years of their index <jats:styled-content style=\"fixed-case\">AEC<\/jats:styled-content> diagnosis. Endometrial cancer was diagnosed in 21 women and cervical cancer in four women during the follow\u2010up period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Cytologic demonstration of <jats:styled-content style=\"fixed-case\">AEC<\/jats:styled-content> requires careful gynaecologic evaluation, particularly in younger women who may be found to have either high\u2010grade squamous (<jats:styled-content style=\"fixed-case\">CIN<\/jats:styled-content>) or glandular (<jats:styled-content style=\"fixed-case\">ACIS<\/jats:styled-content>) lesions, while in older women, the possibility of endometrial neoplasia needs to be considered.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12336","type":"journal-article","created":{"date-parts":[[2015,6,5]],"date-time":"2015-06-05T10:21:39Z","timestamp":1433499699000},"page":"268-273","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Risk of high\u2010grade cervical dysplasia and gynaecological malignancies following the cytologic diagnosis of atypical endocervical cells of undetermined significance: A retrospective study of a state\u2010wide screening population in Western Australia"],"prefix":"10.1111","volume":"55","author":[{"given":"Aime","family":"Munro","sequence":"first","affiliation":[{"name":"Women's Health Clinical Care Unit WA Cervical Cancer Prevention Program Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Williams","sequence":"additional","affiliation":[{"name":"School of Biomedical Sciences Curtin University Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Semmens","sequence":"additional","affiliation":[{"name":"Centre for Population Health Research Curtin University Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yee","family":"Leung","sequence":"additional","affiliation":[{"name":"School of Women's and Infants' Health University of Western Australia Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin J.R.","family":"Stewart","sequence":"additional","affiliation":[{"name":"School of Women's and Infants' Health University of Western Australia Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jim","family":"Codde","sequence":"additional","affiliation":[{"name":"Centre for Population Health Research Curtin University Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrina","family":"Spilsbury","sequence":"additional","affiliation":[{"name":"Centre for Population Health Research Curtin University Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nerida","family":"Steel","sequence":"additional","affiliation":[{"name":"Women's Health Clinical Care Unit WA Cervical Cancer Prevention Program Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Cohen","sequence":"additional","affiliation":[{"name":"School of Women's and Infants' Health University of Western Australia Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"O'leary","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences Curtin University Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,6,5]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Australian Institute of Health and Welfare.Cervical Screening in Australia 2011\u20132012:2013."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605139"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2012.03.023"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1018435522475"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.20138"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1586\/eog.11.74"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2009.05.019"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02644.x"},{"key":"e_1_2_9_10_1","volume-title":"Screening to Prevent Cervical Cancer: Guidelines for the Management of Women with Screen Detected Abnormalities","author":"National Health and Medical Research Council","year":"2005"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.114849"},{"key":"e_1_2_9_12_1","first-page":"249","article-title":"Atypical glandular cells of undetermined significance. Review of final histologic diagnoses","volume":"47","author":"Meath AJ","year":"2002","journal-title":"J Reprod Med"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000202401.29145.68"},{"key":"e_1_2_9_14_1","unstructured":"Australian Bureau of Statistics.Census of Population and Housing: Socio\u2010Economic Indexes for Areas (SEIFA) Australia \u2013 Data Only 2006. (ABS Cat. No. 2033.0.55.001) [Accessed June 2014] Available from URL:http:\/\/www.abs.gov.au\/ausstats\/abs@.nsf\/mf\/2039.0\/."},{"key":"e_1_2_9_15_1","unstructured":"University of Adelaide.ARIA and Accessibility 2014. [Accessed June 2014] Available from URL:https:\/\/www.adelaide.edu.au\/apmrc\/research\/projects\/category\/aria.html."},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.10061"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.20999"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2012-0493-RA"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02769.x"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000152350.10875.02"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2004.00288.x"},{"key":"e_1_2_9_22_1","unstructured":"Australian Government Medical Services Advisory Committee.Application No. 1276 \u2013 Renewal of the National Cervical Screening Program. [Accessed September 2014] Available from URL:http:\/\/www.msac.gov.au\/internet\/msac\/publishing.nsf\/Content\/FD36D6990FFAA639CA25799200058940\/$File\/1276%20-%20Final%20MSAC%20PSD%20-%20NCSP%20Renewal.pdf."},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.12012"}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fajo.12336","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.12336","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T09:13:57Z","timestamp":1695546837000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.12336"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6]]},"references-count":22,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2015,6]]}},"alternative-id":["10.1111\/ajo.12336"],"URL":"https:\/\/doi.org\/10.1111\/ajo.12336","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"value":"0004-8666","type":"print"},{"value":"1479-828X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,6]]},"assertion":[{"value":"2014-10-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-02-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-06-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}