Risk factors for abnormal cervical cytology in women undergoing kidney transplant evaluation

Kevin V. Chaung, Yu Zheng, Anthony T. Martella, Jordan B. Stoecker, Devan R. Cote, Joshua J. Augustine, Edmund Q. Sanchez, Vanessa R. Humphreville, John B. Ammori, Kenneth J. Woodside

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


OBJECTIVES: Cervical cytology screening has been successful in reducing deaths from cervical cancer. We sought to determine risk factors for abnormal Pap test results in women undergoing kidney transplant evaluation.

MATERILAS AND METHODS: We retrospectively examined women undergoing kidney transplant evaluations from 2008 to 2011. Patients were stratified based on normal cytology and atypical/malignant cytology.

RESULTS: Of 404 patients, 293 patients (72.5%) had normal cytologic findings, whereas 111 (27.5%) had abnormal findings. On univariate logistic regression analyses, patients who had chronic kidney disease with an autoimmune cause (odds ratio = 2.71 [95% confidence interval, 1.41-5.19]; P = .003), previous renal transplants (odds ratio = 2.64 [95% confidence interval, 1.20-5.82], P = .016), or age ≤ 50 years (odds ratio = 1.68 [95% confidence interval, 1.08-2.61], P = .022) were more likely to have abnormal findings. Patients with normal and abnormal findings had similar rates of dialysis use. On multivariate logistic regression, patients who had chronic kidney disease with autoimmune causes (odds ratio = 2.48 [95% confidence interval, 1.26-4.88]; P = .008) and who had previous renal transplants (odds ratio = 2.67 [95% confidence interval, 1.20-5.95]; P = .017) were more likely to have abnormal findings.

CONCLUSIONS: Previous kidney transplant, autoimmune disease, and age ≤ 50 years were associated with abnormalities on cervical cancer screening in our female group of patients. Patients with these characteristics may benefit more from routine cervical cancer screening than other patients evaluated for kidney transplant.

Original languageEnglish (US)
Pages (from-to)31-36
Number of pages6
JournalExperimental and Clinical Transplantation
Issue number1
StatePublished - Feb 2019

Bibliographical note

Funding Information:
From the the 1Division of Transplant Surgery, Department of Surgery, the 2Division of Nephrology, Department of Internal Medicine, and the 3Division of General and Oncologic Surgery, Department of Surgery, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, Ohio, USA; and the 4Section of Transplantation Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA Acknowledgements: This study was supported by the Office of Medical Education and Committee of Student Representatives at Case Western Reserve University School of Medicine. The authors have no conflicts of interest to report. We thank Kelly Noon and Genevieve Popp for database assistance. Corresponding author: Kenneth J. Woodside, Section of Transplant Surgery, Department of Surgery, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-5296, USA Phone: +1 734 936 8363 E-mail: woodside@umich.edu

Publisher Copyright:
© Başkent University 2019.

Copyright 2019 Elsevier B.V., All rights reserved.


  • Cancer screening
  • Cervical cancer
  • Cervical cytology screening
  • Chronic kidney disease
  • End-stage renal disease
  • Kidney transplant evaluation
  • Predictive Value of Tests
  • Reoperation
  • Age Factors
  • Papanicolaou Test
  • Humans
  • Middle Aged
  • Risk Factors
  • Incidental Findings
  • Vaginal Smears
  • Uterine Cervical Neoplasms/etiology
  • Autoimmune Diseases/complications
  • Early Detection of Cancer/methods
  • Kidney Transplantation/adverse effects
  • Cervix Uteri/pathology
  • Renal Insufficiency, Chronic/diagnosis
  • Adult
  • Female
  • Retrospective Studies

PubMed: MeSH publication types

  • Journal Article


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