Abstract

Teresa Pusiol, Doriana Morichetti and Maria Grazia Zorzi2

To assess the value of opportunistic screening in diagnosis of invasive squamous carcinoma found in >70 years old women in Trentino (northern region of Italy) in the period 2007 to 2010, the cytopathology Section of Rovereto Hospital examined 28589 opportunistic Pap smears. papillomavirus (HPV) genotyping by polymerase chain reaction (PCR) was performed in all histological specimens with diagnosis of low grade and high grade intraepithelial lesions and invasive cervical carcinoma. 111 cases (0.38%) of cervical intraepithelial neoplasia-3-squamous cell carcinoma were identified in 28589 opportunistic Pap smears. The cytological diagnosis of cervical intraepithelial neoplasia-3 was performed in three cases, confirmed by cone biopsy in two patients with the presence of HPV-16 and HPV-58 with PCR. The diagnosis of keratinizing squamous cell carcinoma was performed with Pap smear in three patients, histologically confirmed by the biopsy with the presence of HPV-58 in one case. Non-keratinizing squamous cell carcinoma was diagnosed with Pap smear in two cases, histologically confirmed by hysterectomy with bilateral salpingo-oophorectomy in absence of HPV. It is necessary to note that early diagnosis decrease to mortality, morbidity and management costs of new cases of cervical cancer diagnosed in > 65 years old women. The present study supports the screening policy to perform Pap test every 3 years until aged 69 years, independently to sexual activity.