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Postcoital bleeding of uncertain use in determining cervical cancer risk

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Synopsis

These authors systematically reviewed several databases looking for English-language studies that reported or provided sufficient data to estimate the incidence or prevalence of postcoital bleeding.

The authors do not report looking for unpublished data, independent and paired application of inclusion criteria, or paired data abstraction.

Ultimately, they included 38 articles. They found no studies that determined how often women presenting with postcoital bleeding subsequently have cervical cancer.

One mass screening study from Finland identified 2,648 women with postcoital bleeding of whom 12 (0.45 per cent) had invasive cancer at the time of presentation.

Eight of the articles (including hundreds of thousands of women) evaluated women in community settings. The overall rate of women complaining about postcoital bleeding is quite variable (0.7 per cent to 9 per cent); however, the large population-based studies report the prevalence at approximately 1 per cent.

It is not known how many of these women will seek medical care. Sixteen studies reported the prevalence of postcoital bleeding in more than 47,000 women with invasive cervical cancer. The range of prevalence in these studies was 0.7 per cent to 39 per cent.

Level of evidence

3a (see www.infopoems.com/concept/ebm_ loe.cfm)

Reference

Shapley M et al. A systematic review of postcoital bleeding and risk of cervical cancer. Br J Gen Pract 2006;56:453-460.

Bottom line: In this systematic review, the rate of postcoital bleeding is highly variable and of uncertain significance.

The best estimate is that approximately one woman in 220 with postcoital bleeding has invasive cervical cancer.

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