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Cervical cancer

Cervical Cancer Risks and Screening in Müllerian Anomalies

Publication Title: 147. Prevalence of cervical cancer screening and cervical dysplasia in patients with Müllerian anomalies at a tertiary care center

Summary

Question
This study examined cervical cancer screening patterns and outcomes among women with Müllerian anomalies (MAs), which are structural abnormalities of the female reproductive tract. The researchers hypothesized that women with MAs may have a higher prevalence of cervical dysplasia (abnormal cervical cells that could lead to cancer) and cervical cancer due to potential immune impairment associated with some MA subtypes.
Why it Matters
Cervical cancer screening is essential for early detection and prevention of disease. Women with Müllerian anomalies may face unique risks due to potential immune system challenges, which can increase susceptibility to cervical dysplasia and cancer. This study provides crucial insights for healthcare providers about the importance of timely screenings for this underserved population. By understanding the screening outcomes in women with MAs, healthcare professionals can develop tailored guidelines to improve care and outcomes for these patients.
Methods
The researchers conducted a retrospective study using medical records from a tertiary healthcare center between 2012 and 2025. They identified 161 women aged 9 to 36 years with MAs who had a cervix. Screening data, including Pap smear results (tests for abnormal cervical cells) and HPV co-testing (checks for high-risk human papillomavirus strains linked to cervical cancer), were analyzed. Follow-up procedures, such as colposcopies (detailed examinations of the cervix) and treatments for cervical abnormalities, were also reviewed.
Key Findings
Among the 161 women with MAs, bicornuate uterus (a uterus with two cavities) was the most common subtype, present in 59% of patients. Of the 143 women who underwent Pap smears, 28% had abnormal results, with low-grade squamous intraepithelial lesions (LSIL, mild abnormal cervical cells) being the most frequent finding. High-risk HPV was detected in 26.1% of patients tested. Follow-up colposcopies revealed varying degrees of cervical dysplasia: 21.7% had CIN-I (mild dysplasia), 13% had CIN-II (moderate dysplasia), and 17.4% had CIN-III (severe dysplasia). Five patients required procedures to remove abnormal cells, including LEEP (loop electrosurgical excision), cryoablation (freezing abnormal cells), and laser conization.
Implications
The findings highlight a significant prevalence of cervical dysplasia among women with Müllerian anomalies, emphasizing the need for timely and regular cervical cancer screenings in this group. Since some MAs are linked to immune impairment, tailored screening protocols could help detect abnormalities earlier and prevent progression to cervical cancer. This research provides a foundation for developing specialized guidelines for managing cervical health in women with MAs.
Next Steps
The authors recommend future prospective trials to better understand the relationship between Müllerian anomalies, immune function, and cervical dysplasia. They also suggest creating unique screening guidelines for women with MAs to improve early detection and outcomes.
Funding Information
This research was supported by the National Institutes of Health (award number 2000028592). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Yale University also provided funding and support for this research.

Full Citation

Fonteh A, Meng K, Vash S, Margetts M, Pelosi E, Stevenson J, Vash-Margita A. 147. Prevalence of cervical cancer screening and cervical dysplasia in patients with Müllerian anomalies at a tertiary care center. Journal Of Pediatric And Adolescent Gynecology 2026, 39: 316-317. DOI: 10.1016/j.jpag.2026.01.192.

Authors

  • Aliah Fonteh

    First Author
    School Building Streamline Icon: https://streamlinehq.comOther Institution

  • Alla Vash-Margita, MD, FACOG

    Last Author
    Yale School of Medicine

    Associate Professor of Obstetrics, Gynecology & Reproductive

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Other Authors

  • Kexin Meng;
  • Sophia Vash;
  • Miranda Margetts;
  • Emanuele Pelosi;
  • Julia Stevenson

Research Themes

Concepts