An analysis of cervical pap smear cytology as a screening procedure in a rural tertiary care hospital
Journal Title: Medpulse International Journal of Pathology - Year 2019, Vol 10, Issue 1
Abstract
Background: Cancer of cervix is the second most common cancer in women in world and one of the leading malignancies seen in Indian women. Cancer of cervix is preventable if diagnosed at the pre-invasive stage with regular intervals of cytological screening by Papanicolaou (PAP) smears. Aims and Objectives: The objective of the study is to evaluate the entire spectrum of types and frequencies of cervical cytological abnormalities on PAP smear according to Bethesda system and to correlate cytology with histopathology wherever possible. Materials and Methods: This is a prospective study conducted at a rural tertiary care centre in Department of pathology from April 2018 to March 2019. After doing Pap stain, conventional pap smears were reported adopting Bethesda system. Results: A total of 3360 cases of pap smears were received. Most women were in the age range of 30–40 years. White per vaginal discharge was the most common complaint, occurring in 20.23% of the women. White discharge was the most commonly noted per speculum abnormal finding (16.76% cases). 90% cases were negative for intraepithelial lesion or malignancy (NILM), 4% showed epithelial cell abnormalities (ECA) and 6% were inadequate. In NILM category, inflammatory/reactive changes were commonest. Bacterial vaginosis was commonest infective etiology. In ECA category, Atypical squamous cells of undetermined significance was most common followed by low‑grade squamous intraepithelial lesion. Overall ECA was common in 31-50 years age group. In the present study overall sensitivity was 87.5%, specificity 98.9%, positive predictive value 94.9%, negative predictive value 97.1%, diagnostic accuracy 96.7%. Conclusion: Pap smear examination is an effective screening and diagnostic procedure for the detection of premalignant and malignant cervical lesions at an early stage. It is also helpful in identifying the infectious etiologies and treatment in developing countries. Thereby helping the clinicians in more efficient management of the patients. Key Word: https://doi.org/
Authors and Affiliations
Neha Mukesh Goel
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