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False Positive Pap Smear Indicates Genitourinary Syndrome

Core Concepts
False positive Pap smears may actually indicate genitourinary syndrome, and local estrogen treatment can be effective in addressing this issue.
TOPLINE: Pap smear results may signal genitourinary syndrome. METHODOLOGY: Study on perimenopausal women with abnormal Pap smears. 96.7% of women treated with local estrogen had normal Pap smears. TAKEAWAY: Local estrogen treatment can prevent unnecessary interventions. IN PRACTICE: Early sign of genitourinary syndrome: false positive cervical dysplasia. SOURCE: Presented at the 2023 Menopause Meeting. LIMITATIONS: No limitations reported. DISCLOSURES: No relevant financial relationships reported.
Nearly all (96.7%) of the women who received local estrogen treatment had a normal Pap smear following therapy. The number of Pap smears conducted in this population represents 50-60% of all Pap smears performed on women.
"In this study, we report an early sign of genitourinary syndrome of menopause: false positive cervical dysplasia caused by cervicovaginal atrophy resulting from decreased estrogen levels during perimenopause."

Key Insights Distilled From

by Brittany Var... at 09-28-2023
False Positive Pap Smear May Indicate Genitourinary Syndrome

Deeper Inquiries

How can healthcare providers improve the accuracy of Pap smear interpretations?

Healthcare providers can improve the accuracy of Pap smear interpretations by considering the possibility of genitourinary syndrome (vaginal atrophy) in perimenopausal women presenting with false positive results. This study highlights the importance of understanding the underlying causes of abnormal Pap smears, such as cervicovaginal atrophy due to decreased estrogen levels. By recognizing this early sign of genitourinary syndrome, healthcare providers can avoid unnecessary interventions and treatments for cervical dysplasia. Additionally, incorporating local estrogen therapy as a potential treatment option can help prevent false positives and reduce the need for invasive procedures.

What are the potential risks of overtreating false positive Pap smears?

Overtreating false positive Pap smears can lead to unnecessary interventions and procedures, resulting in physical, emotional, and financial burdens for patients. In the context of this study, many women who initially presented with cervical dysplasia underwent interventions like colposcopies, biopsies, LEEP excisions, cryotherapy, cone biopsies, and hysterectomies due to cervical atrophy. These procedures can have potential risks and complications, including infection, bleeding, scarring, and psychological distress. Moreover, unnecessary treatments can strain healthcare resources and increase healthcare costs. Therefore, it is crucial to accurately interpret Pap smear results and consider alternative explanations, such as genitourinary syndrome, to avoid overtreating false positives.

How can the findings of this study impact the approach to menopausal healthcare beyond Pap smear screenings?

The findings of this study can significantly impact the approach to menopausal healthcare beyond Pap smear screenings by highlighting the importance of recognizing genitourinary syndrome as a potential underlying cause of false positive results. Healthcare providers can use this information to improve the management of menopausal symptoms and conditions, such as vaginal atrophy, by considering local estrogen therapy as a treatment option. By addressing genitourinary syndrome early on, healthcare providers can prevent unnecessary interventions, reduce healthcare costs, and improve the overall quality of care for menopausal women. This study underscores the need for a comprehensive approach to menopausal healthcare that takes into account the diverse range of symptoms and conditions that women may experience during this life stage.