310 Patterns of Cervical Cytology Testing in African American Women with Vulvar Dysplasia and Carcinoma

Document Type

Conference Proceeding

Publication Date

3-24-2025

Publication Title

Lab Invest

Keywords

adult, African American, aged, cancer screening, Caucasian, conference abstract, controlled study, diagnosis, female, follow up, human, human tissue, intraepithelial neoplasia, major clinical study, retrospective study, squamous cell carcinoma, uterine cervix carcinoma, uterine cervix cytology, vulva cancer, vulva disease, vulvar high-grade squamous intraepithelial lesion, vulvar intraepithelial neoplasia, Wart virus

Abstract

Disclosures: Joseph Atto: None; Ghassan Allo: None Background: Disparities in cervical cytology application and vulvar cancer exist. Vulvar cancers reportedly present at a younger age and advanced stage in African American (AA) women in comparison with Caucasians. The rates of cervical cytology utilization and the presence of a prior or a subsequent cervical abnormality in AA patients with vulvar dysplasias have not been studied. Design: This is retrospective analysis of the rates and results of cervical cytology and high-risk human papilloma virus (hr-HPV) testing data in AA women diagnosed with vulvar invasive squamous cell carcinoma (SqCC), vulvar high-grade squamous intraepithelial lesion (HSIL), and differentiated intraepithelial neoplasia (dVIN), diagnosed between November 2013 and September 2024. Descriptive analyses are used. Results: A total of 67 AA patients with SqCC (14, 21%), HSIL (51, 76%) and dVIN (2, 3%) were identified with median age of 57(27-87) years at time of first diagnosis. A prior cervical cytology was done in 53 (79%) patients (10, 67% in SqCC and 41, 80% in HSIL; 2, 100% in dVIN) at a median of 386(7-6092) days prior to the vulvar diagnosis, being normal in 40(60%) and HSIL in 3(5%) of patients. A prior hr-HPV testing was done in 21 (31%) patients (3, 14% in SqCC and 18, 35% in HSIL) being positive in 10 (21%) patients (2 in SqCC; 8 in HSIL). After the first diagnosis of the vulvar disease, cervical cytology was performed in 36(54%) patients (4 in SqCC; 30 in HSIL; 2 in dVIN), the earliest being at a median of 35 (0-1656) days post vulvar diagnosis, being normal in 25(69%) and ASC-H in 3(8%). Follow-up cervical HPV was done in 31(46%) of patients, being positive in 15 patients. [Formula presented] Conclusions: In this limited study of AA patients with vulvar dysplasia/carcinoma, cervical cytology rates are lower than the reported rates for AA or white women, and revealed a significant pathology in only a minority of patients. Similarly, follow-up cervical cytology and HPV testing was performed at a lower rate, highlighting potential disparity in cancer screening among AA patients.

Volume

105

Issue

3

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