The Incidence of Cervical Intraepithelial Neoplasia or Cervical Cancer in Women Referred With Postcoital Bleeding

Hajer Mohammad; Anne Sofie Espensen; Margrét Björg Arnardóttir; Stinne Holm Bergholdt; Lone Kjeld Petersen

doi:10.1097/LGT.0000000000000808

The Incidence of Cervical Intraepithelial Neoplasia or Cervical Cancer in Women Referred With Postcoital Bleeding

J Low Genit Tract Dis. 2024 Apr 23. doi: 10.1097/LGT.0000000000000808. Online ahead of print.

Authors

Hajer Mohammad¹, Anne Sofie Espensen², Margrét Björg Arnardóttir², Stinne Holm Bergholdt³, Lone Kjeld Petersen

Affiliations

¹ Department of Oncology, Odense University Hospital, Odense, Denmark.
² University of Southern Denmark, Odense, Denmark.
³ Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark.

PMID: 38661331
DOI: 10.1097/LGT.0000000000000808

Abstract

Objectives: The incidence of cervical cancer among patients with postcoital bleeding (PCB) was the primary objective of this study. Furthermore, the proportion of cervical intraepithelial neoplasia requiring treatment and the correlation between PCB and the presence of high-risk human papillomavirus (HPV) was determined. Lastly, the study aimed to identify risk factors among the referred women.

Methods: A retrospective cohort study was conducted at a university hospital in Denmark between January 1, 2017 and December 31, 2019. Women referred with PCB were identified with the ICD diagnosis codes "DN930 Postcoital and contact bleeding" and "DN930B Contact bleeding." Demographic and paraclinical data were extracted from the journals and the supportive systems: Patoweb and the Danish Microbiology Database.

Results: A total of 789 women were included in this study, with only 0.25% (n = 2) diagnosed with cervical cancer and 2.5% (n = 20) diagnosed with cervical intraepithelial neoplasia II-III and adenocarcinoma in situ. Human papillomavirus testing was only conducted in a minority of cases, and a low incidence of high-risk human papilloma virus was detected in the 22 cases, n = 5.

Conclusions: A very low incidence of cervical cancer and high-grade cervical intraepithelial neoplasia reported among women referred with PCB. Prognostic factors as body mass index, smoking, and HPV vaccination status may predict the risk of cervical cancer. Selection criteria like primary testing for hrHPV and cytology as cotests before referral to colposcopy may reduce the number of unnecessary colposcopies.