A retrospective study into the occurrence of cervical glandular atypia in cone biopsy specimens from 1977-1978 with clinical follow-up.

Cervical glandular atypia (CGA) is now increasingly recognized in cone biopsy specimens removed for suspected cervical intra-epithelial neoplasia, although little is known of its natural history or pre-malignant potential. One hundred and eighty-three cone biopsy specimens received in our department during 1977 and 1978 from the City and Women's hospitals, Nottingham were reviewed and assessed for the presence of squamous CIN and CGA. One hundred and sixty-seven cone biopsies contained CIN and 28 of these also contained CGA. Ten cone biopsies contained high-grade CGA, the remaining 17 containing low-grade CGA. One cone biopsy contained high-grade CGA only. Twenty-one of the 28 cases of CGA had been followed up by annual pelvic examination and cervical cytology. None of these cases have developed abnormal cervical cytology or invasive cervical carcinoma after 13 years follow-up, even though 13 cone biopsies contained CGA which appeared to be incompletely excised. We concluded that if CGA is pre-malignant, the latent period for its progression to invasive carcinoma is in excess of 13 years. CGA of either grade is not, in itself, an indication for hysterectomy, allowing a conservative approach to management in the first instance.