Patterns of epithelial cell abnormalities in Pap smears and its clinicopathological and demographic association: a descriptive study from Visakhapatnam city, Andhra Pradesh, India

Abstract

Cervical cancer is the second most common cancer among females worldwide and the most common cancer among females in developing countries including India. 1,2 The importance of cervical cancer further lies in the fact, that the natural history has a long latent phase which enables detection and treatment of the premalignant lesions. The Pap screening test provides a simple, easy and effective means of identifying these lesions 2,3 and the ABSTRACT Background: Cervical cancer is one of the leading cancers amongst women. Periodic pap screening is the simplest way to diagnose precancerous lesions. Factors such as ignorance, poverty poorly developed public healthcare delivery system put women in urban slums at a disadvantage for receiving any health screening activity. Objectives of the present study were to know the prevalence of epithelial cell abnormalities of the cervix among the subjects and to study the association with clinical and demographic characteristics. Methods: A camp based descriptive study was conducted in an urban ward. All women above the age of 20 years were included in the study. Data was recorded using a pretested questionnaire. Study variables included sociodemographic characteristics, symptoms of reproductive tract infection, findings of clinical examination, and Pap smear collection and evaluation. The latter was done from 194 women aged between 20-69 years. Pap smears were made by conventional Pap smear technique and reported according to The Revised Bethesda System of classification 2001(TBS). Results: Among the 194 women, in 8 subjects, the smears collected were unsatisfactory for evaluation. Analysis was done in the remaining 186 subjects. Among the latter, in 83.9%, the smears were negative for intraepithelial lesions (NIEL) and 16.1% revealed epithelial cell abnormalities (ECA). Among those with ECA, Atypical cells of undetermined significance (ASCUS) was identified in 66.67%, Low grade squamous intraepithelial lesions(LSIL) in 16.67%, Atypical squamous cells-cannot exclude HSIL (ASC-H) and Atypical glandular cells-not otherwise specified (AGC-NOS) in 6.67% each and High grade squamous intraepithelial lesions (HSIL) in 3.33%. Epithelial cell abnormalities were more common in women in the age group of 30-60 years (80%), they were more common in those with age at marriage between 13-18 years (63.3%) and in those with age at first child birth between 15-19 years (56.7%). Conclusions: Therefore there is a need for Pap screening at regular intervals through camp based approach in these populations to motivate the women, increase their awareness, ensure follow up and referral and timely intervention in appropriate cases.

A Histopathological Study of Neoplastic Lesions of Uterine Cervix of Peri and Postmenopausal Women

“…From various studies, it is seen that the prevalence of CIN in present study is almost equal with the study conducted by Sinha P et al 3 and Gupta N et al 4 Most cases of severe dysplasia were found in the age group of 41-50 and 51-60 years. It correlates with the findings by Al-Jashamy K. 7 and A. Bhagya Lakshmi et al 8 The incidence of squamous cell carcinoma was also highest in the same age group. This finding supports the theory of evolution of invasive carcinoma from the preceding lesion, i.e.…”

Pattern of cervical lesions, with emphasis on precancer and cancer in a tertiary care hospital of Southern India

“…cervix in a slum area of the city showed that epithelial cell abnormalities were identified by Pap smears in 30 women (16.1%). 5 King George hospital in the city is among the oldest hospitals in the country, catering to people from coastal Andhra Pradesh and adjoining areas of Orissa and Madhya Pradesh. The obstetrics and gynecology services were among the first to be commissioned in the fledgling institute.…”