INTRODUCTIONWorldwide cervical cancer comprises approximately 12% of all cancers in women with an incidence of five lakh new cases reported each year of which almost one fourth of it occurs in India.1 About 1,22,844 new cervical cancer cases are diagnosed annually in India and 67,477 cervical cancer deaths have been reported annually in India.2 It is the second most common cancer in women worldwide but the commonest in developing countries like India. It accounts for 80% of deaths in developing countries like India.3 Cervical screening is currently acknowledged as the most effective approach for cervical cancer control. The dramatic reduction in the incidence of cervical cancer in developed countries is because of widespread use of an effective cytological screening test which can identify the premalignant and malignant lesions of the uterine cervix, which cannot be detected or even suspected by history and clinical examination. 4 Early detection of cervical abnormality at prompt time is the early need for the gynecologist, so as to prevent its progression to cervical intraepithelial neoplasia and invasive cancer thereafter. The factors like easy accessibility of cervix, propensity of cervical epithelial cells to exfoliate, rapid turnover of epithelial cells, evidence of wide spectrum of histological changes
ABSTRACTBackground: The present hospital-based study was conducted to study the incidence of various cervical epithelial abnormalities such as infection, dysplasia and early cervical cancer changes in reproductive age population and its correlation with age, parity, socioeconomic status, clinical symptoms and cervical biopsy findings. Methods: A prospective study was conducted in 300 women of reproductive age group. The cervical smear was taken from all patients by means of the scrape technique using the Ayre's spatula. Pap smear results were considered as positive (abnormal) when they are ASCUS, LSIL, HSIL or Invasive lesion. On persistence of unhealthy cervix/inflammatory smear after a course of antibiotic, direct cervical punch biopsy was taken. Results: Inflammatory smears were seen in 88.0%, ASCUS in 5%, LSIL in 1.4%, HSIL in 0.3% and invasive carcinoma in 0.3% patients. Direct cervical punch biopsy was taken from 13 cases out of 264 with inflammatory smear. Most of these patients had cervicitis (12 cases) while 1 case showed CIN stage 2. All cases of ASCUS and LSIL had infection which showed chronic cervicitis on biopsy. HSIL and Invasive carcinoma showed CIN stage 2 and Carcinoma as their biopsy findings.
Conclusions:The Pap smear is a simple, safe, practical and cost-effective method for early detection of cervical cancer and its precursors. In developing countries like India, it is the most logical screening modality although it has a very low sensitivity, but detection rates could be further improved using liquid-based cytology and the use of endocervical cytobrush.