Pattern of Pap smear cytology: our experience

Authors

  • Arul Anne Rose S. Department of Obstetrics and Gynaecology, Tagore Medical College and Hospital, MGR Medical University, Rathinamangalam, Chennai 127, Tamilnadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20163163

Keywords:

Cervical cancer, Pap smear, Cervical cancer screening

Abstract

Background: To study the pattern of cervical smear abnormalities among patients attending the Gynaecology department in our hospital during the study period, in order to understand the magnitude of the problem in our region and to address the need for effective screening programmes.

Methods: It was a hospital based prospective study over a period of six months. According to our study criteria, pap smears were collected and reported. Frequencies of the epithelial abnormalities were calculated.

Results: A total of 630 pap smears were collected and reported in our study. Among them 256 were normal smears (40.6%), 362 were abnormal smears (57.5%) and 12 smears were unsatisfactory (1.9%). When we analysed the abnormal smears (362 smears), 338 were negative for intraepithelial lesions or malignancy (93.4% of abnormal smears or 53.7% of total smears), and 24 smears were classified as epithelial lesions (6.6% of abnormal smears or 3.8% of total smears). ASC-US, ASC-H, LSIL, HSIL, AGUS, Atypical endocervical cells and squamous cell carcinoma were found in 0.9%, 0.5%, 0.5%, 0.6%, 0.2%, 0.3% and 0.8% respectively.

Conclusions: Our results emphasize that we have to encourage and motivate the women for active screening. It also indicates the need for well-organized screening programmes which already exist in well developed countries in order to reduce the burden of cervical cancer.

References

Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012; Int J Cancer. 2015;136(5):E359-86.

ICO.2014.ICO Information Centre on HPV and Cancer (HPV Information 2014).

Shukla S, Bharti AC, Mahata S, Hussain S, Kumar R, Hedau S, et al. Infection of human papilloma viruses in cancers of different human organ sites. Indian J Med Res. 2009;130(3):222-33.

Miniello G, Saraiya U. Historical survey and Basic cytology. Colour atlas of cytology and colposcopy, 1st ed, CBC Pub;1999:1-22.

Sasieni P, Castanon A, Cuzick J. Effectiveness of cervical screening with age: population based case-control study of prospectively recorded data. BMJ. 2009;339:b2968.

Ghazal-Aswad S, Gargash H, Badrinath P, Al-Sharhan MA, Sidky I, Osman N, et al. Cervical smear abnormalities in the United Arab Emirates: a pilot study in the Arabian Gulf. Acta Cytol. 2006;50(1):41-7.

Parkin DM, Bray F. Chapter 2: The burden of HPV-related cancers. Vaccine. 2006;24(3):S3/11-25.

Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74-108.

Arbyn M , Castellsagué X, de Sanjosé S, Bruni L, Saraiya M, Bray F, et al. Worldwide burden of cervical cancer in 2008.Ann Oncol. 2011;22(12):2675-86.

Gupta S, Sodhani P, Halder K, Chachra KL, Sardana S, Singh V, et al. Spectrum of epithelial cell abnormalities of uterine cervix in a cervical cancer screening programme: implications for resource limited settings. Eur J Obstet Gynecol Reprod Biol. 2007;134(2):238-42.

Mulay K, Swain M, Patra S, Gowrishankar S. A comparative study of cervical smears in an urban Hospital in India and a population-based screening program in Mauritius. Indian J Pathol Microbiol. 2009;52(1):34-7.

Afrakhteh M, Khodakarami N, Moradi A, Alavi E, Shirazi FH. A study of 13315 papanicolaou smear diagnoses in Shohada Hospital. J Fam Reprod Health. 2007;1:74-8.

Turkish Cervical Cancer and Cervical Cytology Research Group. Prevalence of cervical cytological abnormalities in Turkey.Int J Gynaecol Obstet. 2009;106(3):206-9.

Kapila K, George SS, Al-Shaheen A, Al-Ottibi MS, Pathan SK, Sheikh ZA, et al. Changing spectrum of squamous cell abnormalities observed on papanicolaou smears in Mubarak Al-Kabeer Hospital, Kuwait, over a 13-year period. Med Princ Pract. 2006;15(4):253-9.

Ghazal-Aswad S, Gargash H, Badrinath P, Al-Sharhan MA, Sidky I, Osman N, et al. Cervical smear abnormalities in the United Arab Emirates: a pilot study in the Arabian Gulf. Acta Cytol. 2006;50(1):41-7.

Sankaranarayanan R, Gaffikin L, Jacob M, Sellors J, Robles S. A critical assessment of screening methods for cervical neoplasia. Int J Gynaecol Obstet. 2005;89(2):S4-12.

Goldie SJ, Gaffikin L, Goldhaber-Fiebert JD, Gordillo-Tobar A, Levin C, Mahé C, et al. Alliance for Cervical Cancer Prevention Cost Working Group. Cost-effectiveness of cervical cancer screening in five developing countries. N Engl J Med. 2005;353(20):2158-68.

Sankaranarayanan R, Budukh AM, Rajkumar R. Effective screening programmes for cervical cancer in low- and middle-income developing countries. Bull World Health Organ. 2001;79(10):954-62.

Sankaranarayanan R, Nene BM, Dinshaw KA, Mahe C, Jayant K, Shastri SS. A cluster randomized controlled trial of visual, cytology and human papillomavirus screening for cancer of the cervix in rural India. Int J Cancer. 2005;116(4):617-23.

Legood R, Gray AM, Mahe C, Wolstenholme J, Jayant K, Nene BM, et al. Screening for cervical cancer in India: How much will it cost? A trial based analysis of the cost per case detected. Int J Cancer. 2005;117(6):981-7.

Downloads

Published

2016-12-15

Issue

Section

Original Research Articles