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PubMed1998

The clinical importance of cystic squamous cell carcinomas in the neck: a study of 136 cases.

BACKGROUND: Predominantly cystic squamous cell carcinomas in the neck often present without a clinically apparent primary and therefore are frequently considered to be of branchial cleft origin. It is the authors' hypothesis that the anatomic site of the primary carcinoma that produced the neck metastasis can often be predicted on the basis of the histologic features. METHODS: Cases of cystic squamous cell carcinoma in the neck diagnosed between 1971 and 1991 were retrieved from the Otorhinolaryngic Pathology Registry of the Armed Forces Institute of Pathology. Histologic features were reviewed and patient follow-up was obtained and analyzed. RESULTS: In cases wherein the primary site was discovered subsequently, 64% of the primaries were in the lingual or faucial tonsil. An additional 8% of cases were in nasopharyngeal tonsillar tissue. The cases that did not originate in Waldeyer's tonsillar ring generally differed in histologic appearance from the tonsillar cases. The tonsillar primaries were discovered within an average of 12.4 months, but many were not discovered for years (up to 11 years). Most were small, indicating a slower growth of the primary than is usually expected for squamous cell carcinoma. Patients with such carcinomas had a much better prognosis than patients with metastatic squamous cell carcinomas of other upper airway mucosal sites. CONCLUSIONS: In most cases of prominently cystic squamous cell carcinomas in the upper neck, the origin of the primary site will be in faucial or lingual tonsillar crypt epithelium. Knowledge of the probable site of origin allows for more tailored therapy in which the patients can be treated relatively conservatively with surgical excision and subsequent field-limited radiation therapy only, with 77% survival at 5 years. None of the cases reviewed in this study was a branchiogenic carcinoma.

Adult↗

PubMed1998

Squamous atypia in the atrophic cervical vaginal smear: a new look at an old problem.

BACKGROUND: Squamous atypia in postmenopausal (PM) cervical vaginal smears (CVS) only rarely is associated with a biopsy-proven squamous intraepithelial lesion (SIL), and thus most commonly represents an atrophy-associated benign reactive change. METHODS: To distinguish atypical squamous cells of undetermined significance (ASCUS) and SIL from atrophy-associated benign reactive changes, a review of atypical atrophic PM CVS was performed. Ninety CVS exhibiting an atrophic smear pattern were considered appropriate for study. Repeat smears and/or biopsy after local estrogen therapy were requested to distinguish atrophic/reactive from dysplastic changes. RESULTS: Generally, atrophic CVS exhibit uniform nuclear enlargement in the squamous cell population, which, using the criterion of nuclear enlargement alone, would qualify the majority of these cases to be classified as ASCUS. The nuclear enlargement associated with atrophy resolves with the local application of estrogen. Follow-up after local estrogen treatment was available for 84 of 90 patients and revealed 10 cases of SIL (12%) and 9 cases of ASCUS (11%), 6 of which were favored to be of a reactive etiology. Nuclear features most commonly noted in the cases considered to be ASCUS (nonreactive) and SIL were nuclear hyperchromasia and nuclear contour irregularities. CONCLUSIONS: Nuclear enlargement alone is not sufficient for diagnosing ASCUS or SIL in PM CVS. Nuclear enlargement in squamous cells is an expected normal reactive change present in PM CVS that resolves with the application of local estrogen. Nuclear hyperchromasia and irregular nuclear contours remain the most reliable cellular characteristics for diagnosing SIL in atrophic CVS.

Aged↗

PubMed1996

bcl-2 expression and prognosis in squamous-cell carcinomas of the esophagus.

The bcl-2 proto-oncogene is a known inhibitor of apoptosis and may be an important regulator of tumor growth. In the present study, bcl-2-protein expression was investigated by immunohistochemistry and correlated with prognosis in a series of 150 potentially curatively resected squamous-cell carcinomas of the esophagus. For comparison, bcl-2-protein expression was analyzed in normal esophageal mucosa, severe squamous dysplasias and carcinomas in situ. bcl-2 immunoreactivity was found in 40 out of 150 invasive squamous-cell carcinomas; the remaining carcinomas were completely negative. bcl-2-protein expression was found more frequently among poorly differentiated than among well-differentiated tumors (p < 0.0001). No correlation was found between bcl-2-protein expression and the parameters tumor size, depth of invasion and nodal status. Moreover, bcl-2-protein expression had no significant influence on overall survival. Whereas in normal mucosa bcl-2 immunoreactivity was restricted to the basal-cell layer, in 9 out of 15 severe squamous dysplasias and in 7 out of 14 carcinomas in situ bcl-2 staining was detected in all epithelial layers. Thus, bcl-2-protein is frequently expressed in invasive squamous-cell carcinomas of the esophagus and in precursor lesions of esophageal cancer, but has no significant impact on the outcome of esophageal cancer.

Adult↗

PubMed1999

Expression, regulation and clinical significance of bone morphogenetic protein 6 in esophageal squamous-cell carcinoma.

Bone morphogenetic proteins (BMPs) are multifunctional cytokines. BMP-6 is involved in early steps of keratinogenesis. Esophageal squamous-cell carcinoma often shows abnormal keratinization. The aim of this study was to examine the expression and regulation of BMP-6 in esophageal carcinoma and to determine the relationship of its expression with tumor characteristics and survival. Avidin-biotin-peroxidase staining was performed using paraffin-wax-embedded tumor specimens collected from 172 patients with esophageal squamous-cell carcinoma, who underwent potentially curative surgery. Expression of BMP-6 and EGF-receptor in the esophageal-squamous-cell-carcinoma cell line COLO-680N and the hypopharyngeal-squamous-cell-carcinoma cell line FaDu was assayed with specific RT-PCR. In standard cell-cultivation conditions, COLO-680N and FaDu cells showed distinct expression of BMP-6, whereas in serum-free conditions BMP-6 expression was hardly detectable. The addition of EGF or EGF-related growth factors could elevate BMP-6 mRNA content. Immunohistochemically, all 172 tumors exhibited cytoplasmic immunoreactivity for BMP-6. The content of BMP-6 protein was inversely correlated with tumor differentiation (p < 0.01). Univariate survival analysis revealed that 74 patients with tumors of low immunoreactivity had higher 2-year and 5-year survival rates (50.0%/27.7%) than 75 patients with tumors of high immunoreactive scores (33.3%/21.6%). (p < 0.05). We conclude that BMP-6 is expressed in esophageal squamous-cell carcinoma. EGF-receptor activation is crucial for regulation of BMP-6 expression. BMP-6 protein content is correlated with the grade of tumor-cell differentiation and may add to indications of poor prognosis.

Adult↗

PubMed1999

Retinoblastoma-protein (prb) expression and prognosis in squamous-cell carcinomas of the esophagus.

The retinoblastoma gene (RB) is a typical tumor-suppressor gene. Inactivation of RB has been shown in a variety of human cancers, including esophageal squamous-cell carcinomas. In the present study, samples of normal esophageal squamous epithelium (n = 10), severe squamous-cell dysplasias (n = 19), carcinomas in situ (n = 14), invasive squamous-cell carcinomas (n = 172), and 2 continuous esophageal-carcinoma cell lines were immunohistochemically analyzed for pRb expression. The specificity of immunostaining was tested by Western-blot analysis of pRb expression in the cell lines. In normal esophageal epithelium, nuclear pRb expression was restricted to the parabasal cell layer, whereas, in a considerable portion of severe dysplasias and carcinomas in situ, pRb over-expression was found. Among carcinomas, 161 of 172 cases showed pRb expression, as did the 2 esophageal-carcinoma cell lines, whereas 11 carcinomas were negative. Expression of pRb among carcinomas was not correlated with pT category, pN category or tumor grade. In the univariate survival analysis, patients with pRb-negative tumors showed lower 2-year and 5-year survival rates (27.3%/9.1%) than patients with pRb-positive tumors (42.8%/25.8%; not significant). In conclusion, pRb protein can be detected by immunohistochemistry in a high percentage of squamous-cell carcinomas of the esophagus and its precursor lesions. However, expression of the pRb protein has no significant impact on the prognosis. Int. J. Cancer (Pred. Oncol.) 84:618-622, 1999.

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PubMed1998

Metastatic squamous-cell carcinoma in pericardial effusion: report of four cases, two with cardiac tamponade.

For reasons unknown, metastatic squamous-cell carcinoma is a rare cause of pleural effusions and is even less common in pericardial effusions. A review of all pericardial effusions examined in the Cytology Service at Montefiore Medical Center over a 15-year (1980-1994) period was undertaken (N = 251). Four cases with metastatic squamous-cell carcinoma were identified among 39 malignant effusions. Two patients with metastatic squamous-cell carcinoma presented with cardiac tamponade, and the other two cases had progressive cardiac failure. The diagnostic cells on cytology evaluation were scant in all four cases but exhibited classical features of metastatic squamous carcinoma, such as cytoplasmic keratinization, intercellular bridges, and occasional "pearl" formation. Pericardial biopsies available in three patients, two with cardiac failure and one with cardiac tamponade, were negative. In all four cases the primary tumor was a bronchogenic carcinoma. Metastatic squamous-cell carcinoma is an uncommon cause of pericardial effusion and usually indicates the presence of a bronchogenic carcinoma with a rapidly fatal outcome. Cytologic examination of pericardial fluid is essential in the evaluation of such patients.

Adult↗

PubMedDate not supplied

Epithelial dysplasia and squamous cell carcinoma of the Wistar rat palatal mucosa: 4NQO model.

BACKGROUND: The carcinogen 4-nitroquinoline 1-oxide (4NQO) has been used in several studies concerning experimental oral carcinogenesis to induce squamous cell carcinoma in the palatal mucosa of rats, whereas limited attention has been paid to preceding premalignant mucosal changes. The aim of this study was to describe the macroscopic and microscopic changes of the rat palatal mucosa treated with 4NQO as a function of the application time of this carcinogen. METHODS: The carcinogen 4NQO was applied to the palatal mucosa of male Wistar rats three times a week for 2-26 weeks. The Epithelial Atypia Index (EAI) was used to quantify the degree of dysplasia induced by the application of 4NQO for various time intervals. RESULTS: This study shows that the EAI increases as a function of the application time. As soon as 2 weeks following application of the carcinogen, dysplastic alterations in the mucosa were observed. The extent and grade of the dysplastic changes increased with time. At week 26, squamous cell carcinoma developed. In rats in which the application of 4NQO was discontinued earlier, the application period appeared to be in inverse proportion to the latency period i.e., the period between the last application of the carcinogen and the first clinical sign of squamous cell carcinoma. This emphasizes the premalignant character of the induced epithelial changes, because in all the rats squamous cell carcinoma eventually developed. CONCLUSIONS: From this study, we concluded that the 4NQO rat palate model is a proper model in which both premalignant epithelial lesions and squamous cell carcinoma of the oral mucosa can be studied.

4-Nitroquinoline-1-oxide↗

PubMed1998

Staurosporine-induced versus spontaneous squamous metaplasia in pre- and postmenopausal breast tissue.

Breast cancers from pre- vs. postmenopausal women display unique characteristics that may be related to differences in epithelial differentiation between these two populations. In addition to lobular development, lactational changes, and involution, breast epithelium can undergo metaplastic alterations, often in association with carcinoma. Because protein kinase C (PKC) regulates differentiation and proliferation in many cell types, we asked whether modulation of PKC activity could define biochemical differences in breast epithelium from pre- vs. postmenopausal women. Organ cultures of normal human breast were treated with PKC agonists and antagonists. Epithelial differentiation was evaluated based on morphologic criteria and the expression of cell-type specific proteins. Staurosporine, a nonspecific but extremely potent inhibitor of PKC, induced squamous metaplasia in eight of eight cases within 2 weeks of treatment. Other inhibitors of PKC, such as calphostin C and tamoxifen, had no effect on epithelial differentiation. Long-term treatment with phorbol esters also did not induce squamous metaplasia. However, stimulation of cAMP levels by forskolin and isobutyl-methyl-xanthene (IMX) rapidly induced squamous metaplasia, as has been previously reported. Surprisingly, squamous metaplasia occurred in 10 of 12 cultures derived from postmenopausal women in the absence of exogenous agents. Untreated cultures derived from premenopausal women never developed this type of epithelium (0 of 11). Therefore, breast epithelium from pre- and postmenopausal women responded differently to in vitro culture. Forskolin/IMX or staurosporine can reproduce these conditions, acting independent of menopausal status. Because staurosporine's action was unique among PKC inhibitors, staurosporine may induce squamous metaplasia of breast epithelium by a PKC-independent mechanism.

Adult↗

PubMed1977

Radioimmunoassay for tumor antigen of human cervical squamous cell carcinoma.

A heterologous antiserum for human cervical squamous cell carcinoma was prepared and specificity determined by Ouchterlony immunodiffusion and immunofluorescence studies. With this antiserum, a tumor antigen was purified from human cervical squamous cell carcinoma tissue. The specificities of the antigen and the antiserum were then re-examined by a radioimmunoassay method using 125 I-labeled purified antigen. Although normal cervical tissue extract showed a moderate cross-reactivity in the radioimmunoassay, the circulating antigen activity could not be detected in normal women or in several patients with carcinomas, whereas 27 of 35 patients with cervical squamous cell carcinoma showed detectable serum antigen activity. All aptients with advanced stages of cervical squamous cell carcinoma showed detectable antigen levels. These results indicate that there is a quantitative abnormality, at least, of this tumor antigen in patients with cervical squamous cell carcinoma and that the radioimmunoassay for the antigen is a potentially useful tool in clinical care.

Antibody Specificity↗

PubMed1986

Small cell carcinoma (non-oat cell type) of the esophagus concomitant with invasive squamous cell carcinoma and carcinoma in situ. A case report.

A case of double primary invasive carcinoma of the esophagus, consisting of well-differentiated squamous cell carcinoma and non-oat cell small cell carcinoma without squamous differentiation, is presented. This is the first reported case of a double or multiple primary invasive carcinoma of the esophagus in which one component is small cell carcinoma (oat cell or non-oat cell). Furthermore, the mucosal epithelium around the non-oat cell small cell carcinoma revealed multiple dysplasia and carcinoma in situ. These lesions were definitely separated from the invasive carcinoma and from each other. The results suggest that pure non-oat cell small cell carcinoma of the esophagus without squamous differentiation is derived from the esophageal squamous epithelium, and is a variant of squamous cell carcinoma.

Aged↗

PubMed1986

Primary squamous cell carcinoma with its spindle cell variant in the endometrium. A case report and review of literature.

A case of squamous cell carcinoma of the endometrium in a 72-year-old woman is presented. A review of the previous 28 cases of endometrial squamous cell carcinoma (ESCC) that are adequately substantiated in the literature revealed several misconceptions about this rare tumor: the association with pyometra is not as frequent; the lesion does occur in premenopausal women; squamous metaplasia of the endometrium is not always coexistent; and malignant transformation of squamous metaplasia to ESCC has never been convincingly demonstrated. In the current case, a focal sarcomatoid spindle-cell tumor was associated with typical ESCC; however, light and electron microscopic examinations provided convincing evidence that the tumor was composed solely of ESCC. Ultrastructure of the spindle-cell tumor revealed it to be essentially identical to that of a spindle-cell variant of squamous cell carcinoma reported previously.

Aged↗

PubMed1990

Tumor-antigen 4. Its immunohistochemical distribution and tissue and serum concentrations in squamous cell carcinoma of the lung and esophagus.

The immunohistochemical distribution and concentrations of tumor-antigen 4 (TA-4) in tissues and serum were determined in patients with benign and malignant diseases, including 27 patients with squamous cell carcinoma (SCC; 15 in the lung and 12 in the esophagus). Tumor-antigen 4 immunoreactivity was present in the cytoplasm of many SCC tissues, especially in the hyperparakeratotic region, and in the cytoplasm of differentiated squamous cells of the intermediate layer of normal epithelia of various organs, but not in those of other types of lung cancers or benign pulmonary diseases. Consistent with the results of immunostaining, the TA-4 concentrations in SCC tissues of the lung, esophagus, and normal squamous epithelia were much higher than in those of lung cancer other than SCC, benign pulmonary diseases, normal lung, and submandibular gland tissues. The TA-4 concentration in SCC tissue tended to increase with increasing grades of differentiation. Serum TA-4 was elevated in 15 of 27 patients with SCC but in no patients with other types of lung cancer or benign diseases. These results indicate that TA-4 is an antigen related to the differentiation of squamous cells and that tumor cells of SCC can release a large amount of TA-4 into circulation whereas normal squamous epithelia cannot.

Aged↗

PubMed1994

Serum level of squamous cell carcinoma antigen and tumor size are useful to identify preoperatively patients at high risk of cervical cancer.

BACKGROUND: The benefit of postoperative adjuvant therapy for patients with cervical cancer is uncertain, and moreover, may increase morbidity. In this study, patient age, clinical stage of the cancer, tumor size, and levels of serum squamous cell carcinoma cell antigen and carcinoembryonic antigen were studied in patients with Stage Ib and IIa squamous cell carcinoma of the uterine cervix to determine if these parameters can be used, before the surgical intervention, to distinguish patients who require postoperative adjuvant therapy from those who do not. METHODS: Ninety-nine patients were studied. After surgery, patients were classified either as high risk or low risk according to the results of histopathologic findings. The age of the patient was noted, and FIGO stage, squamous cell carcinoma antigen, carcinoembryonic antigen, and clinical tumor size were determined. A univariate analysis and then a stepwise logistic regression procedure were performed to select significant clinical predictors from among the five variables mentioned above. Any selected predictors were further analyzed by the receiver operator characteristic curve. RESULTS: Serum squamous cell carcinoma antigen and clinical tumor size measured by colposcopic examination were significant clinical predictors of the treatment strategy postoperatively. From the receiver operator characteristic curve, a sensitivity of 84.2%, a specificity of 91.8%, a positive predictive value of 84.5% were attained. CONCLUSIONS: Serum squamous cell carcinoma antigen assays and clinical tumor size estimated by colposcopic examination are helpful in identifying patients who require postoperative adjunctive therapy.

Adult↗

PubMed2001

Paclitaxel, carboplatin, and long-term continuous infusion of 5-fluorouracil in the treatment of advanced squamous and other selected carcinomas: results of a Phase II trial.

BACKGROUND: The purpose of this study was to evaluate the feasibility, toxicity, and efficacy of the combination of paclitaxel, carboplatin, and long-term continuous infusion 5-fluorouracil (5-FU) in the treatment of advanced squamous carcinomas of various primary sites. METHODS: Patients were eligible for this trial if they had metastatic squamous carcinoma at any site except the lung. In addition, patients with locally advanced squamous carcinoma of the head and neck were eligible, if they were considered unlikely to be cured with combined modality therapy. Sixty patients entered this trial between February 1995 and March 1999; 12 patients (20%) had received 1 previous chemotherapy regimen, whereas 48 patients (80%) were previously untreated. All patients received the following regimen: paclitaxel 200 mg/m(2), 1-hour intravenous infusion, Days 1 and 22; carboplatin area under the concentration-time curve (AUC) 6.0 intravenously, Days 1 and 22; 5-FU 225 mg/m(2)/day, by 24-hour continuous intravenous infusion, Days 1-35. Treatment courses were repeated at 6-week intervals; responding patients continued treatment for a maximum of 4 courses (24 weeks). RESULTS: Thirty-nine of 60 patients treated (65%) had objective responses to this regimen, with 25% complete responses. Twelve patients (22%) remain progression free from 7 to 63 months (median, 35 months) after completion of therapy. Complete responses were observed in squamous carcinomas from various primary sites including head and neck, esophagus, cervix, vagina, anus, and unknown primary. The most frequent Grade 3/4 toxicities observed with this 3-drug regimen included leukopenia (48%), diarrhea (17%), mucositis (28%), and portacath-related events (13%). CONCLUSIONS: The combination of paclitaxel, carboplatin, and long-term infusional 5-FU is feasible, well tolerated, and highly efficacious in patients with advanced squamous carcinomas of various primary sites. This regimen merits further investigation.

Adult↗

PubMed2001

Translation initiation factor eIF-4G is immunogenic, overexpressed, and amplified in patients with squamous cell lung carcinoma.

BACKGROUND: Recently, the authors reported identification and cloning of several novel immunogenic antigens in squamous cell lung carcinoma. Of 14 corresponding genes, 9 mapped in an amplified chromosomal region with the gene for eIF-4G that was amplified most frequently. METHODS: Recombinant eIF-4G was expressed in E. coli and screened with sera from patients with squamous cell carcinoma of the lung and of the head and neck. Protein extracts from squamous cell carcinoma tissues were analyzed for eIF-4G expression by Western blot analysis. Mutation analysis was performed using an automatic DNA sequencer. RESULTS: The authors screened a spectrum of 33 heterologous sera from lung carcinoma patients and detected antibodies against eIF-4G in 5 of these sera (15%). They found no immune response to eIF-4G in 17 sera from squamous cell carcinoma tissues derived from the head and neck. In addition, no antibodies were found to eIF-4G in a group of 17 control sera from individuals without known tumor formation. Sequence analysis of the eIF-4G gave no indication of mutations. To analyze the expression of eIF-4G, a monoclonal antibody was used. Western blot analysis clearly showed overexpression in the tumor tissue compared with the corresponding normal lung tissues. CONCLUSIONS: The translation initiation factor eIF-4G is the first protein in which the gene shows amplification, has increased expression in a human tumor, and induces an immune response in patients. eIF-4G lends itself as a marker for the diagnosis of and possibly as a future therapeutic target in patients with squamous cell lung carcinoma.

Antibody Formation↗

PubMed2000

Papillary squamous cell carcinomas of the upper aerodigestive tract: a clinicopathologic and molecular study.

BACKGROUND: The limited studies and the small number of published cases of papillary squamous cell carcinoma have precluded accurate assessment of the biologic characteristics of this lesion. METHODS: Thirty-eight of the carcinomas were studied. In-situ hybridization and polymerase chain reaction were performed to detect human papilloma virus (HPV) and p53 expression. RESULTS: HPV was found in 4 of 14 assessable carcinomas by in-situ hybridization and in 5 of 14 by polymerase chain reaction. The most frequently identified HPVs were HPVs in 6/11 and 16/18 patients. In general, a reciprocal relationship was found between p53 and HPV prevalence. The most lethal site for this tumor was the sinonasal tract, whereas patients with papillary squamous cell carcinomas of the larynx had the best outlook. Eleven of 25 (44%) assessable patients died of disease (mean time interval, 2 year). CONCLUSIONS: Papillary squamous cell carcinoma of the upper aerodigestive tract is a distinct variant of squamous cell carcinoma. As such and because of its putative association with HPV, papillary squamous cell carcinoma could be an informative model for defining how viral oncogenes cooperate with other factors in genomic instability, carcinogenesis, and tumor development.

Adult↗

PubMed2003

Obesity as a potential risk factor for adenocarcinomas and squamous cell carcinomas of the uterine cervix.

BACKGROUND: Hormonal factors may play a more prominent role in cervical adenocarcinoma than squamous cell carcinoma. The authors evaluated whether obesity, which can influence hormone levels, was associated with adenocarcinoma and squamous cell carcinoma. METHODS: This case-control study included 124 patients with adenocarcinoma, 139 matched patients with squamous cell carcinoma, and 307 matched community control participants. All participants completed interviews and provided cervicovaginal samples for human papillomavirus (HPV) testing. Polytomous logistic regression-generated odds ratios (ORs) and 95% confidence intervals (95% CIs) for self-reported height and weight, body mass index (BMI; kg/m(2)), and measured waist-to-hip ratio (WHR) for both histologic types were adjusted and stratified for HPV and other confounders. RESULTS: Height, weight, BMI, and WHR were positively associated with adenocarcinoma. BMI >or= 30 kg/m(2) (vs. BMI < 25 kg/m(2); OR, 2.1 and 95% CI, 1.1-3.8) and WHR in the highest tertile (vs. the lowest tertile; OR, 1.8 and 95% CI, 0.97-3.3) were associated with adenocarcinoma. Neither height nor weight was found to be associated with squamous cell carcinoma, and associations for BMI >or= 30 kg/m(2) (OR, 1.6) and WHR in the highest tertile (OR, 1.6) were weaker and were not statistically significant. Analyses using only HPV positive controls showed similar associations. The data were adjusted for and stratified by screening, but higher BMI and WHR were associated with higher disease stage at diagnosis, even among recently and frequently screened patients with adenocarcinoma. Thus, residual confounding by screening could not be excluded as an explanation for the associations. CONCLUSIONS: Obesity and body fat distribution were associated more strongly with adenocarcinoma than with squamous cell carcinoma. Although questions about screening remain, obesity may have a particular influence on the risk of glandular cervical carcinoma.

Adenocarcinoma↗

PubMed2005

Outcome after a cervical cytology report of low-grade squamous abnormality in Australia.

BACKGROUND: The current study was undertaken to assist with providing an evidence-based approach to the management of women with cervical cytology reports of low-grade squamous abnormality as used in the Australian organized screening program. METHODS: Using the Pap Test Registers, an audit was performed of the outcome over 24 months of Australian women who received an index cervical cytology report of low-grade squamous abnormality in 1999. RESULTS: Information was available for 76,709 of the 90,566 women whose first cytology report in 1999 was of a low-grade squamous abnormality. Forty-one cases of histologically confirmed cervical carcinoma were diagnosed during the subsequent 24 months (10 Stage IA, 31 Stage IB or worse). Five of the 10 women who were diagnosed with Stage IA carcinoma during the 24 months of follow-up had an intervening cervical biopsy of high-grade intraepithelial abnormality. The risk of cervical carcinoma diagnosis during the 24 months was 0.05% (95% confidence interval [CI], 0.03-0.07%) for the women with nonspecific minor change index cytology, 0.03% (95% CI, 0.00-0.07%) for the women with human papillomavirus index cytology, and 0.07% (95% CI, 0.03-0.11%) for the women with Grade 1 cervical intraepithelial neoplasia index cytology. CONCLUSIONS: Cervical carcinoma was a very rare outcome within 2 years of a cytology report of low-grade squamous abnormality in Australia. A simplified terminology for low-grade squamous cervical cytology reports should be considered by Australia, with uniform management for asymptomatic women.

Adult↗