Cervical polyps in postmenopausal women: is there a difference in risk?

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Abstract

Objective:

The aim of this study was to evaluate cervical polyps and assess whether postmenopausal women are at higher risk for abnormalities than their premenopausal counterparts.

Methods:

After institutional review board approval, the Hartford Hospital pathology database was retrospectively searched for cases of endocervical polyps removed from September 1999 through January 2008, inclusive. The presence of malignancy, dysplasia, and atypia was recorded, along with demographic information.

Results:

A total of 2,458 polyps were analyzed. The mean ± SD age was 48.6 ± 10.7 years, with a range from 16 to 95 years. Most specimens were from private offices (95%) and obstetrics and gynecology practices (98.5%). The population was 82.5% white, 3.5% African-American, 5.2% Hispanic, 0.4% Asian, and 8.3% "other." For the women younger than 50 years, the prevalence of malignancy, dysplasia, and atypia within a cervical polyp was 0.1%, 0.7%, and 1.9%, respectively, compared with 0.1%, 0.2%, and 1.1% for the women 50 years or older (P = 0.846, 0.063, and 0.144, respectively). The prevalence of "any abnormality" (malignancy, dysplasia, or atypia) within the polyp among women younger than 50 years was 2.7% compared with 1.4% in women 50 years or older (P = 0.034). Most atypia was found in the teens and 20s; most dysplasia in the 30s to 50s; and most cancers in perimenopause to postmenopause (≥48 y).

Conclusions:

The prevalence of any abnormality within a cervical polyp is significantly lower in postmenopausal, compared with premenopausal, women. Younger women (teenagers to 20s) have little risk associated with cervical polyps. Middle-aged women (30s-50s) have a higher risk of dysplasia. Women in the perimenopausal to postmenopausal years have a slightly higher likelihood of a malignancy associated with cervical polyps.

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