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Cervical polyps in postmenopausal women: is there a difference in risk?

Schnatz, Peter F. DO1-6; Ricci, Stephanie MD1,3,5; O'Sullivan, David M. PhD7

doi: 10.1097/gme.0b013e3181927286
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Objective: The aim of this study was to evaluate cervical polyps and assess whether postmenopausal women are at higher risk for abnormalities than their premenopausal counterparts.

Methods: After institutional review board approval, the Hartford Hospital pathology database was retrospectively searched for cases of endocervical polyps removed from September 1999 through January 2008, inclusive. The presence of malignancy, dysplasia, and atypia was recorded, along with demographic information.

Results: A total of 2,458 polyps were analyzed. The mean ± SD age was 48.6 ± 10.7 years, with a range from 16 to 95 years. Most specimens were from private offices (95%) and obstetrics and gynecology practices (98.5%). The population was 82.5% white, 3.5% African-American, 5.2% Hispanic, 0.4% Asian, and 8.3% "other." For the women younger than 50 years, the prevalence of malignancy, dysplasia, and atypia within a cervical polyp was 0.1%, 0.7%, and 1.9%, respectively, compared with 0.1%, 0.2%, and 1.1% for the women 50 years or older (P = 0.846, 0.063, and 0.144, respectively). The prevalence of "any abnormality" (malignancy, dysplasia, or atypia) within the polyp among women younger than 50 years was 2.7% compared with 1.4% in women 50 years or older (P = 0.034). Most atypia was found in the teens and 20s; most dysplasia in the 30s to 50s; and most cancers in perimenopause to postmenopause (≥48 y).

Conclusions: The prevalence of any abnormality within a cervical polyp is significantly lower in postmenopausal, compared with premenopausal, women. Younger women (teenagers to 20s) have little risk associated with cervical polyps. Middle-aged women (30s-50s) have a higher risk of dysplasia. Women in the perimenopausal to postmenopausal years have a slightly higher likelihood of a malignancy associated with cervical polyps.

The presence of any abnormality in cervical polyps is lower in postmenopausal women compared with premenopausal women.

From the Departments of 1Obstetrics and Gynecology and 2Internal Medicine, Hartford Hospital, Hartford, CT; Departments of 3Obstetrics and Gynecology and 4Internal Medicine, University of Connecticut, Farmington, CT; Departments of 5Obstetrics and Gynecology and 6Internal Medicine, The Hospital of Central Connecticut, New Britain General Campus, New Britain, CT; and 7Department of Research Administration, Hartford Hospital, Hartford, CT.

Received October 13, 2008; revised and accepted October 23, 2008.

Financial disclosure: None reported.

A portion of these data were presented orally, in abstract form, on October 13, 2006, at the 17th Annual Meeting of The North American Menopause Society in Nashville, TN.

Address correspondence to: Peter F. Schnatz, DO, FACOG, Department of ObGyn, The Hospital of Central Connecticut, New Britain General Campus, 100 Grand St., New Britain, CT 06050. E-mail: pschnat@harthosp.org or pschnatz@THOCC.org

©2009The North American Menopause Society