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Histological outcome of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (asc-h) papanicolaou smears diagnosed at Groote Schuur hospital
Background - Cervical cancer imparts a huge burden on South African women and the healthcare system, making up 17.33% of all cancers in females. Cervical cytology screening, assessed under the Bethesda system, forms an integral part of this effort. Within this system, the Atypical Squamous Cells, ca...
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| Format: | Thesis |
| Language: | English English |
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Department of Pathology
2025
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| _version_ | 1867613273268944896 |
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| access_status_str | Open Access |
| author | Wessels, Raisa |
| author2 | Chokoe Maluleke, Mmaphuti Jackie |
| author_browse | Chokoe Maluleke, Mmaphuti Jackie Wessels, Raisa |
| author_facet | Chokoe Maluleke, Mmaphuti Jackie Wessels, Raisa |
| author_sort | Wessels, Raisa |
| collection | Thesis |
| description | Background - Cervical cancer imparts a huge burden on South African women and the healthcare system, making up 17.33% of all cancers in females. Cervical cytology screening, assessed under the Bethesda system, forms an integral part of this effort. Within this system, the Atypical Squamous Cells, cannot exclude High grade squamous intraepithelial lesion (ASC-H) category is said to carry a positive predictive value for High grade Squamous Intraepithelial neoplasia (HSIL) that lies between Atypical Squamous Cells of Uncertain Significance (ASC-US) and HSIL. Aim: The aim of this study was to assess the histological outcome of the ASC-H Papanicolaou smears diagnosed between January 2009 and December 2019 and to compare the yield of high grade histology with the literature. Methods: A computerized search of the Laboratory Information Systems (LIS) at Groote Schuur Hospital yielded 1694 ASC-H cases. Results: Of the 1694 cases identified, 699 cases had data on histology. Of the 699 cases with histology data, the majority of cases showed High Grade Squamous Intraepithelial Lesion (HSIL) on histology (n=271, 38.8%). There were 225 (32.1%) cases of Low grade Squamous Intraepithelial Lesion (LSIL), 75 (10.7%) showed normal histology, 40 (5.7%) cases showed cervicitis, 26 (3.7%) cases showed squamous cell carcinoma, 25 (3.6%) cases were suboptimal for assessment, 21(3.1%) cases showed squamous metaplasia and 16(2.3%) cases reflected diagnoses falling into an “other” category (which includes entities such as benign polyps and glandular lesions). Conclusion: With the larger proportion of cases showing HSIL, the intention of the ASC-H category to identify likely high risk cervical changes and expedite follow-up colposcopy, biopsy and management has been proven. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/41970 |
| institution | University of Cape Town (South Africa) |
| language | English eng |
| last_indexed | 2026-06-10T12:33:31.121Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | Department of Pathology |
| publisherStr | Department of Pathology |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/41970 Histological outcome of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (asc-h) papanicolaou smears diagnosed at Groote Schuur hospital Wessels, Raisa Chokoe Maluleke, Mmaphuti Jackie Ikumi, Nadia Cervical cancer Groote Schuur Background - Cervical cancer imparts a huge burden on South African women and the healthcare system, making up 17.33% of all cancers in females. Cervical cytology screening, assessed under the Bethesda system, forms an integral part of this effort. Within this system, the Atypical Squamous Cells, cannot exclude High grade squamous intraepithelial lesion (ASC-H) category is said to carry a positive predictive value for High grade Squamous Intraepithelial neoplasia (HSIL) that lies between Atypical Squamous Cells of Uncertain Significance (ASC-US) and HSIL. Aim: The aim of this study was to assess the histological outcome of the ASC-H Papanicolaou smears diagnosed between January 2009 and December 2019 and to compare the yield of high grade histology with the literature. Methods: A computerized search of the Laboratory Information Systems (LIS) at Groote Schuur Hospital yielded 1694 ASC-H cases. Results: Of the 1694 cases identified, 699 cases had data on histology. Of the 699 cases with histology data, the majority of cases showed High Grade Squamous Intraepithelial Lesion (HSIL) on histology (n=271, 38.8%). There were 225 (32.1%) cases of Low grade Squamous Intraepithelial Lesion (LSIL), 75 (10.7%) showed normal histology, 40 (5.7%) cases showed cervicitis, 26 (3.7%) cases showed squamous cell carcinoma, 25 (3.6%) cases were suboptimal for assessment, 21(3.1%) cases showed squamous metaplasia and 16(2.3%) cases reflected diagnoses falling into an “other” category (which includes entities such as benign polyps and glandular lesions). Conclusion: With the larger proportion of cases showing HSIL, the intention of the ASC-H category to identify likely high risk cervical changes and expedite follow-up colposcopy, biopsy and management has been proven. 2025-10-02T09:02:01Z 2025-10-02T09:02:01Z 2025 2025-10-02T08:35:30Z Thesis / Dissertation Masters MMed http://hdl.handle.net/11427/41970 en eng application/pdf Department of Pathology Faculty of Health Sciences University of Cape Town |
| spellingShingle | Cervical cancer Groote Schuur Wessels, Raisa Histological outcome of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (asc-h) papanicolaou smears diagnosed at Groote Schuur hospital |
| thesis_degree_str | Master's |
| title | Histological outcome of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (asc-h) papanicolaou smears diagnosed at Groote Schuur hospital |
| title_full | Histological outcome of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (asc-h) papanicolaou smears diagnosed at Groote Schuur hospital |
| title_fullStr | Histological outcome of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (asc-h) papanicolaou smears diagnosed at Groote Schuur hospital |
| title_full_unstemmed | Histological outcome of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (asc-h) papanicolaou smears diagnosed at Groote Schuur hospital |
| title_short | Histological outcome of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (asc-h) papanicolaou smears diagnosed at Groote Schuur hospital |
| title_sort | histological outcome of atypical squamous cells cannot exclude high grade squamous intraepithelial lesion asc h papanicolaou smears diagnosed at groote schuur hospital |
| topic | Cervical cancer Groote Schuur |
| url | http://hdl.handle.net/11427/41970 |
| work_keys_str_mv | AT wesselsraisa histologicaloutcomeofatypicalsquamouscellscannotexcludehighgradesquamousintraepitheliallesionaschpapanicolaousmearsdiagnosedatgrooteschuurhospital |