As women age, atypical Papanicolaou smears are associated with more advanced cervical neoplasia. The woman under age 30 has less than one chance in a hundred of having invasive carcinoma if she has an atypical Papanicolaou smear, while the woman over age 60 has one chance in six of this finding. An atypical Papanicolaou smear does not necessarily mean neoplasia is present; 23% of the women evaluated for atypical smears had a negative evaluation, and this included women over age 60. Endocervical currettings containing neoplastic tissue frequently are seen after age 30 and may contribute significant information to the final diagnosis; stenosis of the endocervix, however, may prevent curettage in postmenopausal women. Diagnostic conizations of the cervix rarely are necessary prior to age 30 if colposcopic technics are used. The need for conizations increases by decade of age and is required in at least one-third of postmenopausal women evaluated initially by colposcopy.
© 1977 The American College of Obstetricians and Gynecologists