Cervical screening and treatment guidelines for precancerous lesions may benefit from the additional layer of context that a new JAOA study offers on the impact of race.
JAOA Research

Study: Cervical lesions change fastest in Hispanic women, slowest in black women

Original research in the Journal of the American Osteopathic Association offers evidence-based context to help DOs care for patients with abnormal Pap results.

According to new research in The Journal of the American Osteopathic Association, the rates at which precancerous cells in the cervix progress toward becoming cancerous or regress toward normal vary among Hispanic, black, white, and Asian women.

The retrospective cohort study analyzed medical records of 5,472 women receiving a Pap test between January 2006 and September 2016, and charted the progression of abnormal cell development, from the atypical but innocuous (ASC-US) lesions to low-grade (LSIL) to high-grade (HSIL), the type most likely to develop into cancer. Researchers also studied the rates at which lesions regressed from HSIL to ASC-US stage.

“We see race-based differences that influence treatment protocols in all manner of health issues,” said Daniel Martingano, DO, an ob-gyn at New York University Langone Hospital—Brooklyn and lead author on this study. “Unfortunately, screening and treatment guidelines for precancerous lesions have not yet benefited from that additional layer of context. This study is the first step toward more precise and effective care.”

We see race-based differences that influence treatment protocols in all manner of health issues. …
This study is the first step toward more precise and effective care.

Hispanic women progressed the fastest, moving from innocuous to worrisome high-grade lesions within 17.6 months, whereas black women took 27.6 months to reach that critical state. However, Hispanic women recovered faster too, regressing from high-grade to innocuous lesions in 28.1 months. On average black women took 49 months to regress back to the innocuous stage.

Progression and regression rates of precancerous lesions for white and Asian women fell in between, reflecting more closely the expected patterns upon which current treatment guidelines are based.

Dr. Martingano says his research may help physicians feel more confident in making their treatment decisions and hopes it leads to fewer women undergoing aggressive and invasive procedures.

For full details, read the complete original research, “Variations in Progression and Regression of Precancerous Lesions of the Uterine Cervix on Cytology Testing Among Women of Different Races.”

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