Diagnosis of "ASCUS" in women over age 50 is less likely to be associated with dysplasia.

Many investigators have found that cervical dysplasia is common when follow-up data are obtained from patients with a diagnosis of atypical squamous cells of undetermined significance (ASCUS). This study tests the hypothesis that ASCUS in older women is less likely to predict dysplasia than in younger women, and quantifies the difference. We constructed a retrospective case/control cohort from patients diagnosed with ASCUS by our service in 1997. Follow-up information was obtained on 150 patients over age 50 and a temporally matched control cohort under age 50. In women under 50, our control group, we found that 29.5% of patients had dysplasia on follow-up. This number is similar to that seen in many studies in the literature. In comparison, women over 50 showed only 12.8% of patients with any level of dysplasia. This difference is statistically significant by chi-square analysis, at P = 0.0077. A diagnosis of ASCUS in women over 50 yrs old is 2.3-fold less likely to be associated with dysplasia than that diagnosis in younger patients. Copyright 2001 Wiley-Liss, Inc.