New research suggests that women with poor quality Pap smears appear more likely to develop changes in their cervix that lead to cancer. "The clinical and prognostic significance of inadequate smears is unknown," said Dr. Ye Lin Hock of Manor Hospital in Walsall, West Midlands, and colleagues.

Researchers followed a cohort of 1,972 women with an inadequate Pap smear for five years. Two percent of the women developed precancerous lesions during follow-up, compared to 1 percent of all women with cervical smear tests reported at the same laboratory over the same time period. Smears for which multiple reasons were listed for inadequacy showed the strongest link between poor quality smears and precancerous lesions.

The authors noted that their findings support current recommendations in the United Kingdom that women with inadequate smears receive further tests due to their greater risk for precancerous lesions. "The way forward in our opinion would be for the National Health Service Cervical Screening Program to study the outcome (if possible nationally) of inadequate smears, and to formulate its guidelines for further management based upon the evidence," Hock and co-authors wrote. Their report, "Outcome of Women with Inadequate Cervical Smears Followed Up for Five Years," was published in the Journal of Clinical Pathology (2003;56;(8):592-595).

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