Spectrum of Cervical Pap Smears in a Tertiary Teaching Hospital in Manipur, India

Abstract

Background and Objective: Cervical cancer is a worldwide leading cause of morbidity and mortality among women. This is a retrospective study to evaluate the pattern of cervical smear abnormalities and to assess the role of Pap smear screening in detecting early cervical cancer among women attending a tertiary teaching hospital in Manipur, India, for 1 year. Materials and Methods: Pap smear reports and slides of all women over the age of 21 years who visited the gynaecology outpatient department during this one year were retrieved and reviewed. The smears were obtained using Ayre's spatula and endocervical brush spread on two clean glass slides for each patient, which were immediately wet-fixed in 95% ethyl alcohol, stained by Pap stain and subsequently examined by trained cytopathologists of the cytopathology division of the pathology department. Frequencies of all the findings including epithelial abnormalities were calculated. Results: There were a total of 1,562 cases in the age range of 21-84 years.Vaginal discharge was the most common symptom. The majority of 1,499 (95.97%) of the cases were negative for intraepithelial lesion or malignancy. Epithelial cell abnormalities 63 (4.04%) including atypical squamous cells of undetermined significance, low-grade squamous intraepithelial lesions and high-grade squamous intraepithelial lesions were seen in 3.27, 0.26 and 0.51%, respectively. Conclusion: Pap smear test is a simple, safe and cost-effective screening tool to detect pre-invasive cervical lesions. There is a need for well-organized screening programmes to motivate every sexually active woman above the age of 21 years to undergo active cervical screening, to reduce the burden of cervical cancer.