Atypical glandular cells on cervical cytology are most often associated with which management step in women over 35?

Atypical glandular cells found on cervical cytology indicate potential abnormalities that could be linked to a range of cervical and endometrial pathologies. In women over the age of 35, the presence of these cells raises particular concern due to the higher risk for both cervical and endometrial neoplasia.

The preferred management step for women in this age group involves a colposcopy combined with endometrial biopsy. This approach allows for both a thorough examination of the cervix through colposcopy and the opportunity to sample the endometrium for any abnormalities. This dual approach is critical, as atypical glandular cells can arise not only from cervical lesions but also from endometrial issues, making it vital to rule out malignancies or pre-cancerous changes in both areas.

Colposcopy facilitates direct visualization of the cervix, enabling targeted biopsies of any suspicious areas. Meanwhile, the endometrial biopsy addresses the potential for endometrial pathology that could be indicated by the atypical glandular cells.

In summary, the correct management step for women over 35 with atypical glandular cells on cervical cytology is to perform colposcopy with endometrial biopsy to ensure comprehensive evaluation and appropriate follow-up.