Study of Cervical PAP Smear in a Tertiary Care Hospital

Abstract

Introduction: Cervical cancer is an increasing health problem, comprising approximately 12% of all cancers among women worldwide. India has the highest age standardized incidence of cervical cancers in South Asia. By simple pap screening test cervical cancer and its precursor lesions can be detected and treated early. The present study was conducted to study the different patterns of cervical lesions in a tertiary care hospital. Material and methods: This retrospective study was conducted in the department of pathology of Pathology AIMSR, Bathinda over a period of one year. A total of 231 cases were included in the study. Prepared slides dipped in ethyl alcohol in coplin jar were received in the Pathology department. Slides were air-dried and stained with Pap stain. Reporting was done by two cytopathologists according to the Bethesda Classification System. Results: Maximum number of cases were in the age group 30-39 years constituting 34.19% of the total cases followed by age group 20-29 years. The oldest case was of age 81 years. Minimum percentage (0.86%) of cases were under 80-89 age group. Vaginal discharge was the commonest chief complaint followed by menorrhagia and lower abdominal pain.Maximum number of cases reported as Non-Specific Inflammatory Smears (57.57%). Among epithelial cell abnormalities incidence of ASCUS and ASCUS-H was 0.86% followed by SCC (0.43%). Conclusion: Pap smear testing is an economical, non-invasive and simple OPD procedure to detect potentially precancerous and cancerous lesions of cervix. It should be established as a routine screening procedure to reduce the treatment burden, morbidity and mortality.

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

“…It was observed that vaginal discharge was the most common (38%) presenting complaint in our study, which is comparable to other studies 2,4,14 . There were 1,499 (95.97%) cases of NILM, with the most common lesion 1,149 (72%) being of non-specific inflammation, similar to studies by others 2,4 . The ECA was detected in 4.04% of the cases, comparable to the ECA detection rates of 0.5% and 8.48% in various studies [2][3][4]7,8,11,14 (Table 3).…”

“…The majority 641 (41%) of the women in the study group were from the reproductive age group (20-40 years), similar to studies by others 4,7,13 . It was observed that vaginal discharge was the most common (38%) presenting complaint in our study, which is comparable to other studies 2,4,14 .…”

“…Cervical cancer is a major public health problem, being the fourth most common cancer as well as the fourth leading cause of cancer deaths worldwide among women in 2018 1 . In many developing countries like India, it is the second most common cancer with over 75% of incidence and mortality [1][2][3][4] .…”

“…Unlike most other malignancies, cervical cancer is easily detected and highly treatable in the early stages of development or carcinoma in situ, due to the long pre-invasive stage and well-defined pre-malignant lesions, if robust screening programmes are implemented [3][4][5][6] .…”

“…The Pap smear test was first introduced in 1941 and has now become the primary standard screening test and is being used globally for the detection of pre-cancerous Cervical Intraepithelial Neoplasia (CIN) and the early stage of invasive cervical cancer. Not only does a Pap smear play a crucial role in detecting cancer but it also helps in the diagnosis of inflammatory lesions, identification of causative organisms and cervical epithelial changes due to therapeutic agents 4,10 . A Pap smear test is performed using a brush or spatula (Ayre's spatula) to gently scrape the cellular material from the squamocolumnar junction of the cervical canal and this material is smeared onto a clean glass slide.…”