Effect of Obesity in Persistent or Remission in Postmenopausal Women with Atypical Cervical Cytology

OBJECTIVES: To determine the effects of obesity in pre and postmenopausal women diagnosed with atypical squamous cells of undetermined significance (ASC-US) (in cases of remission, persistence, and progression of disease) after initial management and follow-up within 2 years to inform proper management for postmenopausal Thai women. METHODS: This retrospective study was conducted at Bhumibol Adulyadej Hospital, Thailand between January 2013 and October 2018. Medical records of 506 patients whose cervical cytology reported of ASC-US were reviewed. Prevalence of silent high grade cervical intraepithelial neoplasia (CIN2/3) was evaluated. Cervical cytology after completed follow-up within 2 years were determined. RESULTS: During the study period, there were 506 cases of ASC-US cytology reported. One quarter of cases were of post-menopausal status. Prevalence of CIN 2/3 in ASC-US cytology in pre and postmenopausal women were 9.9 and 7.2%, respectively. At 2-year follow-up appointments, around 90% of patients who completed follow-up remained in remission of the disease in both age groups. Menopausal status, body mass index (BMI), sexual activity, number of sexual partners, parity, smoking and hormone replacement therapy were not correlating factors to remission. Obese postmenopausal women had a lower remission rate of CIN, but this finding was not statistically significant. CONCLUSION: Obesity was not found to correlate strongly with the progression or remission of CIN. Obese postmenopausal women may still be affected by a persistence of the disease. Continuing cervical cytology monitoring should be recommended for such patients. Silent high grade cervical intraepithelial neoplasia (CIN2/3) in ASC-US cytology in this study were high. Colposcopy should be recommended for diagnosis and follow-up in this setting.