Cervical intraepithelial neoplasia in postmenopausal women with negative cervical cytology.

Cervical intraepithelial neoplasia in postmenopausal women with negative cervical cytology Four cases of cervical intraepithelial neoplasia were detected among 50 postmenopausal women in whom cytological examination of a cervical smear yielded negative results, indicating the need for cytological surveillance of women into old age. Cytological and colposcopic examination of the cervix was performed in 50 women presenting to a menopausal clinic with symptoms of the climacteric before they began hormone replacement treatment. The mean (SD) age was 50-38 (4.51) years with a mean postmenopausal time of 31 (33'87) months. No patient was known to have had a previous dyskaryotic smear or a clinically suspicious cervix, and repeat colposcopic and cytological examinations were performed if the patient returned after at least two months' hormone replacement treatment. The women underwent 101 colposcopic examinations, at which cytological smears were obtained. Initial cytological findings, were negative in all patients. One smear had a suspicious appearance on review, and colposcopy and biopsy confirmed a subclinical papilloma'virus infection of the cervix without intraepitheial neoplasia. None of the rnng 49 patients showed cytological abnormalities during the study. Colposcopic examination in these 49 patients disclosed that 11 had an atypical transformation zone (table). Acetowhite epithelium (in which a Details of patients with negative results on cytological examination and atypical transformation zone