Analysis of 100 cervical pap smears for screening of cervical cancer at a tertiary care teaching hospital (original) (raw)
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Journal of Clinical and Basic Research (JCBR), 2023
Background: Cervical cancer is the most frequent cause of death for women in developing countries. India, the second-most populous nation in the world, accounts for about 25% of cervical cancer deaths. Even in its premalignant stage, cervical cancer can be detected using a Papanicolaou (Pap) smear test. The goal was to study the role of Pap smear in detecting premalignant, malignant, and non-neoplastic lesions of the cervix and to ascertain the frequency of different lesions. Methods: All women who visited the obstetrics and gynecology outpatient department (OPD) at GMERS Medical College and Hospital, Navsari, India, in 1 year for different clinical problems were recruited. A total of 322 women who were sexually active and over 21 years of age were enrolled in the study. A Pap smear was used for all the women to screen for cervical cancer. The smear was obtained using an Ayre spatula and spread over a marked glass slide, which was placed in 95% ethyl alcohol and sent to the Department of Pathology for cytopathological examination. Women who had visible malignant cervical lesions were excluded. All the data were recorded in a predetermined form. Results: A total of 322 patients were screened. Out of 322, 261 smears were NILM (negative for intraepithelial lesion or malignancy) and 126 (39.1 %) smears had inflammatory changes; 2.2 % and 1.2% smears showed changes as ASCUS (atypical squamous cells of undetermined significance) and ASC-H (atypical squamous cells cannot exclude high-grade squamous intraepithelial lesions), respectively; 4.7 % and 5.3% smears showed LSIL (low-grade squamous intraepithelial lesion) and HSIL (high-grade squamous intraepithelial lesion). Squamous cell carcinoma was observed in only 2 (0.6%) of the smears. A total of 16 (4.9%) smears were unsatisfactory for evaluation because they lacked sufficient squamous components or were obscured by inflammation. Conclusion: The Pap smear test is a very easy, non-invasive, useful, simple, safe, and economical tool to detect preinvasive cervical epithelial lesions. It is evident and proven that every woman above the age of 30–35 years must be subjected to cervical screening, and this must be continued even in the postmenopausal period.
Cancer of the cervix is the most common cancer in women and is the leading cause of morbidity and mortality in developing countries like India. Cancer of cervix is readily preventable and can be diagnosed at the pre-invasive stage with adequate and repetitive cytological screening with Papanicolaou (Pap) smears. OBJECTIVES This is a retrospective study aimed to evaluate all cervical smears examined at a teaching tertiary hospital during a 6-month period. METHODS Detailed clinical data and Pap smear cytology reports were obtained. All the Pap smears were reported as per the 2001 Bethesda system. RESULTS A total of 468 Pap smears were examined. Maximum number of patients was in the age group of fourth decade. There were 29 unsatisfactory or inadequate samples (6.1 %). A total of 391 smears were reported as Negative for intraepithelial lesion or malignancy (NILM), of which 51 (13.04 %) showed normal cytological findings and 294 (75.19 %) were inflammatory. Out of a total 439 Pap smears...
Indian Journal of Forensic Medicine & Toxicology, 2021
Background: Cancer cervix is fourth most common cancer in the world and second most common in India. In India, cervical cancer is the leading cause of mortality and morbidity amongst women. Methodology: This prospective study was conducted among 200 women undergoing Pap Smear Test at gynecology OPD between January-June 2020. Pap smear test was classified as per Bethesda system. Result: Abnormal pap smear report was seen among 25.5% women. Higher proportion of abnormal pap report was seen among women aged 21-30 years (41.17%), with a duration of married life between 10-20 years 33.3%. The common abnormal pap smear report finding were inflammatory changes and vaginosis. Epithelial cell abnormalities were found among 18 (9%) women. Conclusion: Pap smear test is a simple, affordable, effective, and practical screening test for early detection of cervical cancer, and it decreases morbidities and mortalities due to cervical cancer.
Pap smear: A cost effective method of screening of cervical cancer in a tertiary care centre
International Journal of Clinical Obstetrics and Gynaecology
Cervical cancer is one of the commonest cancer cause of death among women worldwide. >80% of all the cervical cancer cases are found in developing and low-resource countries, because of a lack of awareness and difficulty in running cytology-based screening programs. Conventional Pap smear testing has been the mainstay of most of the screening programs. Cervical cytology screening by Pap smear has been proven to decrease the incidence and mortality of cervical cancer.
Cervical Cancer Screening Using Pap Smear- A Hospital Based Study
IOSR Journals , 2019
Background: Cervical cancer is a major cause of death in women world wide especially in the developing countries. Lack of universal and effective screening programme using Pap smear is one of the reasons for delayed diagnosis. Objective: The study aims to identify and analyze abnormal Pap smear reports to plan treatment. Methods: It is a prospective observational study conducted over a period of 2 years from June 2016 to May 2018 at Government Victoria Hospital, Visakhapatnam. The study included all women attending the Gynaecology OPD between the ages 15 -70 years who were sexually active. A total of 4200 women were screened using Pap test and unsatisfactory smear was seen in 48 cases. The women with unsatisfactory smears were excuded from the study and those women with satisfactory smears were tabulated and analysed using SPSS version 22. Results: The maximum number of smears were taken in the age groups 31-40 years and 21-30 years which are 1630(39.25%) and 1455(35.05%) respectively. The most common clinical presentation was vaginal discharge with 2486 women (62.4%). Normal smears were seen in 854 cases (22.46%), inflammatory smears in 2790 cases (73.4%). Epithelial cell abnormality constituted 351(8.45%) of total cases screened. Atypical squamous cell of undetermined significance (ASCUS) was the commonest epithelial cell abnormality (43.87%) followed by LSIL (20.22%), HSIL (15.66%) and AEC-NOS (9.97%).Squamous cell carcinoma constituted 7.12% of epithelial cell abnormality. Conclusions: Pap smear is a simple screening test for cervical cancer which can prevent morbidity and mortality associated with it.
A clinical audit of Pap smear test for screening of premalignant and malignant cervical lesions
International journal of reproduction, contraception, obstetrics and gynecology, 2022
Background: Cervical cancer, the second most common type of cancer in females, can be easily screened and prevented by Papanicolaou smear test which is a very simple, effective and inexpensive testing modality. The clinical audit aimed to estimate the rate of routine testing as well as the prevalence of various findings of Pap smear tests done at a tertiary level hospital. Methods: It was an analytical cross-sectional study that utilised results of 100 pap smear tests chosen against a set of exclusion and inclusion criteria out of the total 719 pap smears done at Adesh Medical College and Hospital between the duration of 1 January 2022 to 31 May 2022. Results: Only 4.29% of total patients that attended gynaecology OPD got a Pap smear done. A mere 22% patients of those under study came for routine testing. 93% of these 100 patients were negative for intraepithelial lesions, of which 42% were normal, 35% showed non-neoplastic changes and infection was seen in 16% of patients. 7% showed epithelial cell abnormality and 0% had malignant changes. Conclusions: The acceptance of Pap smear for routine screening continues to be low in the Indian setting. There is a massive need to spread awareness among the general public about the importance of Pap smear Test.
Utility of Pap smear in detection of cervix cancer in females: A clinical study
International Journal of Clinical Obstetrics and Gynaecology
Background: Cancer of uterine cervix is a leading cause of mortality and morbidity among women worldwide. The present study was conducted to determine the efficacy of Pap smear in detection of cancer cervix. Materials & Methods: The present study was conducted in the department of Gynecology & Obstetrics on 510 females of age ranged 18-70 years. After a vaginal examination, cervical smears were taken with the help of Ayer's spatula and cyto brush to collect specimen from the squamocolumnar junction. The cellular material obtained on the spatula and cyto brush was quickly smeared on a clean glass slide. The smears were stained with Papanicolaou stain (PAP stain) and slides were examined under light microscope following 2001 Bethesda system. Results: Age group 18-30 years had 102 patients, 31-40 years had 132, 41-50 years had 120, 51-60 years had 84 and 61-70 years had 72. The difference was significant (P-0.01).In age group 18-30 years, maximum patients showed unsatisfactory results (25) followed by normal (20), HSIL (16), inflammatory (15), atrophy (12). In age group 31-40 years, maximum patients showed unsatisfactory results (30) followed by inflammatory (27), normal (25), atrophy (14). In age group 41-50 years, maximum patients had inflammatory (23), followed by normal (22) and unsatisfactory results (15). In age group 51-60 years, maximum patients had HSIL (16) followed by normal (15), inflammatory (12) and ASCUS (12). In age group, maximum patients had HSIL (14) and ASCUS (13). The difference was significant (P<0.05). Conclusion: Pap smears appear efficient in screening for early detection of premalignant and malignant lesions of cervix. Early intervention should be employed to prevent developing lesions of cervix in females.
National Journal of Community Medicine, 2011
The study was conducted to explore various lesions of Uterine cervix [inflammatory and growth], to find out target age group in which screening efforts can be concentrated for early detection as well as reduction of the incidence of cervical cancer, in our set up. Patients in the age group 15-50 and 50-78 years with various complaints were screened during June 2006 to December 2007. Total 995 patients were studied. Slides were fixed in 95% ethyl alcohol and stained with Pap stain. Slides were reported according to the 2001 Bethesda System, by cytopathologists. Out of 995 patients studied, 940 showed inflammation and other benign lesions. 55 patients showed premalignant and malignant lesions. Premalignant lesions were present in 30-50 year of age group.
PAP SMEAR: AN IMPORTANT SCREENING TECHNIQUE FOR PREVENTING AND DETECTING CERVICAL CANCER
Continental J. Medical Research , 2010
Background: Cervical cancer is the second most preventable cancer in women worldwide, and the fifth leading cause of cancer deaths. Cervical cancer is less common than it once was in developed nations due to early detection through Pap smear technique. However, in developing countries especially the Sub Saharan region, the number of deaths resulting from cervical cancer is unquantifiable as a result of inaccurate data. Method: A review of literature, utilizing the PUBMED and those obtained through nominal search and general text books was done to determine the epidemiology, overview, screening methods and obstacles, risk factor, guideline for prevention and health promotion of cervical cancer through Pap smear on women of child bearing age.
A Study on Effectiveness of Pap Smear in Mass Screening of Premalignant Lesions of Cervix
SBV Journal of Basic, Clinical and Applied Health Science
Background and objectives: A study on the accuracy of Pap smear was conducted in Pantai Hospital, Sungai Petani, Malaysia involving 125 patients from the Department of Obstetrics and Gynaecology. Cervical cancer is a significant health issue for women; being the second most common cancer among women in Malaysia hence early detection of precancerous lesions can prevent progression to cervical carcinoma. The objective of this study was to measure the sensitivity, specificity, positive predictive value, negative predictive value, percentage of false-negative, percentage of false-positive and yield of Pap smear by comparing Pap smear results with colposcopy guided cervical biopsy. Materials and methods: The study was conducted among 125 patients who have undergone both Pap smear and colposcopy-guided cervical biopsy using a cross-sectional study with a purposive sampling method. The data obtained were analyzed statistically. Results: 125 patients participated in this study, giving Pap smear a sensitivity of 38%, specificity of 64%, positive predictive value of 80.85%, negative predictive value of 20.51%, false-positive for intraepithelial lesion or malignancy of 38%, false-negative for intraepithelial lesion or malignancy 62%. Of the total 125 patients studied, 62.4% were indicated to have a cervical biopsy due to clinical suspicion and among them biopsy report was positive for intraepithelial lesion or malignancy in 79.5%. Conclusion: The sensitivity and specificity of Pap smear as a screening tool for precancerous cervical lesions is low. It is therefore inadequate to be used alone as a screening tool. The study also shows that having a high index of clinical suspicion even when the Pap smear results were normal was important in order not to miss a precancerous cervical lesion as early detection can prevent progression to cervical cancer. Hence, a more experienced doctor with a high index of clinical suspicion is vital.