False positive pap smear may be early signal of genitourinary syndrome, suggests study

They investigated 1500 women aged 30-70 from several clinics. The women had a low risk for sexually transmitted infections, a maximum of two sexual partners, and the presence of cervical dysplasia over 12 years.

The researchers reported the following findings:

• Nearly all (96.7%) of the women who received local estrogen treatment had a normal Pap smear following therapy.
• A high number of patients who initially presented with cervical dysplasia underwent interventions such as biopsies, colposcopies, cryotherapy, LEEP excisions, cone biopsies, and hysterectomies because of cervical atrophy.
• Local estrogen treatment could save patients money spent on treatments for cervical atrophy.
• Some women who underwent cone biopsies and hysterectomies and did not receive local estrogen still had vaginal dysplasia.

The researchers reported an early sign of genitourinary syndrome of menopause: false positive cervical dysplasia caused by cervicovaginal atrophy resulting from reduced estrogen levels during perimenopause.

"We also demonstrated how the use of local estrogen therapy can prevent a significant number of procedures and interventions, leading to significant cost savings," the researchers wrote. "This is particularly relevant as the number of Pap smears conducted in this population represents 50-60% of all Pap smears performed on women.

The authors of the study reported no limitations.

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The data were presented at the 2023 Menopause Meeting of the North American Menopause Society on September 27.