Evaluation of atypical glandular cells of undetermined significance: Is age important?

OBJECTIVE: Our purpose was to assess the effect of age on the incidence of significant pathologic findings in patients with atypical glandular cells of undetermined significance. STUDY DESIGN: This retrospective study evaluated nonreferred patients with Papanicolaou smears showing atypical glandular cells of undetermined significance over a 5-year period. RESULTS: Two hundred eighty-one women (91%) with Papanicolaou smears showing atypical glandular cells of undetermined significance were available for follow-up. Significant abnormality was found in 90 subjects (32%), including 31 women (11%) with cancer. Older patients (greater than or equal to 50 years old) have lower odds of high-grade cervical dysplasia (odds ratio = 0.21; 95% CI: 0.32-0.40) and higher odds of uterine cancer (odds ratio = 12.88; 95% Cl: 1.78-567.60) compared with younger patients. CONCLUSIONS: Women with Papanicolaou smears showing atypical glandular cells of undetermined significance have a 1 in 3 chance of having significant abnormality. Evaluation includes colposcopy, endocervical curettage, and appropriate cervical biopsies. Patients > 45 years require endometrial biopsies.