# The occurrence of cervical high-grade lesions in women outside the recommended age screening

## TL;DR

This study found that cervical high-grade lesions occur in women outside the recommended screening age, with younger women having more transient lesions and older women showing more severe cases due to lack of earlier screening.

## Contribution

The study provides evidence on the prevalence of cervical high-grade lesions in women outside the standard screening age range in Brazil.

## Key findings

- 15.5% of women with CIN 2+ were outside the recommended screening age.
- CIN 2 was most common in women under 25, while CIN 3 and invasive cancer were more frequent in older age groups.
- The findings suggest that screening younger women may lead to unnecessary treatment, while older women may have missed earlier screening opportunities.

## Abstract

This study aimed to assess the prevalence of cervical High-Grade Squamous Intraepithelial Lesions (HSIL) in women outside the screening age recommended by the Brazilian Guidelines for Cervical Cancer Screening (under 25 and over 64 years old).

The cross-sectional study was conducted at a reference hospital in Rio de Janeiro with a histopathological report of CIN 2 + from January 2010 to December 2020 through the analysis of medical records.

Among 406 women diagnosed with Cervical Intraepithelial Neoplasia (CIN) 2+, 63 patients (15.5%) were outside the recommended screening age, 17(4.2%) of whom were under the age of 25, and 46 (11.3%) were older than 64 years. CIN 2 was most prevalent in women under 25 years old (29.4%); CIN 3 in those between 25 and 64 years old (55.1%); and invasive cancer predominated in women over 64 years old, with statistical significance (<0.001).

The higher frequency of CIN 2 in young women under 25 years old supports the transient nature of these lesions, reinforcing that screening this age group may lead to unnecessary treatment. Conversely, the detection of high-grade lesions and cancer in older women is a consequence of inadequate screening earlier in life.