Clinicopathological determinants of vaginal and premalignant-malignant cervico-vaginal polyps of the lower female genital tract

J Low Genit Tract Dis. 2011 Jul;15(3):210-8. doi: 10.1097/LGT.0b013e31820b7e0f.

Abstract

Objective: To establish pathology frequencies for polyps in the vagina and cervix and to identify determinants of vaginal polyps and premalignant-malignant cervico-vaginal polyps.

Materials and methods: The pathology reports of all cervico-vaginal polyps examined for 6 years at a single institution were classified, and frequencies were calculated. In 2 separate case-control studies, clinical and pathological variables of vaginal cases were compared with cervical controls, and premalignant-malignant cases were compared with benign controls. Differences in variables that were abstracted from patients' chart and pathology reviews were tested for significance.

Results: There were 4,402 polyps; 4,340 cervical (98.6%), 62 vaginal (1.4%), 4,268 benign (97.0%), 62 premalignant-malignant (1.4%) (CIN, endometrial hyperplasia, and carcinoma), and 72 unsatisfactory (1.6%). Age was a significant determinant of vaginal and premalignant-malignant polyps, and polyp size and number were significant determinants of vaginal polyps. Vaginal polyps were 3 times more frequent among women 40 years and younger and twice as frequent among those 60 years and older (p < .001). Premalignant-malignant polyps were twice as frequent among women 40 years and younger (p = .04), and malignant polyps were 6 times more frequent in those 60 years and older, which approached statistical significance (p = .09). Multiple polyps were 2 times more frequent (p = .04) and greater than 2 cm was 4 times (p = .01) more frequent among vaginal polyps.

Conclusions: Vaginal polyps and premalignant-malignant cervico-vaginal polyps are rare. Vaginal polyps are larger and multiple and cervico-vaginal polyps in younger and older women are at greater risk of premalignant-malignant changes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Alberta / epidemiology
  • Case-Control Studies
  • Cervix Uteri / pathology*
  • Female
  • Humans
  • Middle Aged
  • Neoplasms, Glandular and Epithelial / epidemiology
  • Neoplasms, Glandular and Epithelial / pathology
  • Polyps / epidemiology*
  • Polyps / pathology*
  • Precancerous Conditions / epidemiology
  • Precancerous Conditions / pathology*
  • Risk Factors
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / pathology
  • Vagina / pathology*
  • Young Adult