Implications of inflammatory changes on cervical cytology.

OBJECTIVE To assess premenopausal women with inflammatory changes on cervical cytology for genital infections and cervical abnormalities. DESIGN Prospective study of women attending general practice and family planning clinics who had a recent cervical cytology result with inflammatory changes. SETTING Department of genitourinary medicine. PATIENTS 102 Premenopausal women with recent cytology result showing inflammatory changes and with no history of antibiotic or antifungal treatment since their smear. INVESTIGATIONS Genital examination and microbiological screening for genital infections; colposcopic examination about six weeks later. MAIN OUTCOME MEASURES Detection of genital infections, particularly those sexually acquired, and abnormalities on colposcopy. RESULTS Genital infections were isolated in 77 patients, and one or more sexually acquired infections were found in 22. Prevalence of sexually acquired infections was significantly correlated with younger age (particularly being under 25), being single, separated, or divorced; using non-barrier contraception; and recent change of sexual partner. An abnormality on colposcopy was found in 36 women. There was a strong correlation of a sexually acquired infection with an abnormality at colposcopy; hence younger women were more likely to have a colposcopic abnormality. CONCLUSIONS Inflammatory changes on cytology are often associated with the presence of a sexually acquired infection and premalignant disease of the cervix, particularly in younger, single women using non-barrier contraception.