A Clinical Audit of Pap Smear Test for Screening of Cervical Cancer

Background: Cervical cancer is a leading cause of mortality and morbidity among women worldwide and most common gynaecological cancer in developing countries. Papanicolaou smear is a simple and cost effective screening test for cervical cancer. The aim of this study is to evaluate and interpret the cervical pap smear cytology in a tertiary hospital. The interpretation and reporting of the pap smear is based on 2001 Bethesda system. Materials and methods:This is a prospective study conducted in a tertiary hospital, Nepal Medical College over a period of two and a half years (January 2013 to June 2015). All cervical pap smears received in the department of Pathology in the study period were included.Results: A total of 4160 cervical pap smears were reported in the study period. Majority of the cases were Negative for Intraepithelial lesion or malignancy (87.9%). Bacterial vaginosis, atrophy and reactive cellular changes associated with inflammation were seen in 5.3%, 2.4% and 1.5% cases respectively. Epithelial cell abnormalities (0.5%) include Atypical squamous cells of undetermined significance, Low grade squamous intraepithelial lesion and High grade intraepithelial lesion. 88% of Low grade squamous intraepithelial lesion was seen in reproductive age group (20-45 years). Conclusion:Cervical cancer is the most common gynaecological cancer in the developing countries. Pap smear is the simple and cost effective screening tool to detect pre invasive cervical epithelial lesions.

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“…1 cervical cancer in the world. Over 2100 cases of cervical cancer are reported in Nepal each year, with a case-fatality rate of over 50%.…”

Section: Introductionmentioning

confidence: 99%

Cervical pap smear- A prospective study in a tertiary hospital

et al. 2015

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“…9,10 Twenty two low grade squamous intraepithelial lesions (LSIL) and four frank malignant cases were detected in 1062 pap smear examination. 9 In a study of 1922 pap smear, there was 0.4% high grade squamous intraepithelial lesions (HSIL). In another study done in Dhulikhel hospital, 1.3% moderate SIL, 6.7% SIL and 5.3% frank malignancy were detected in 75 cervical biopsy.…”

Section: Introductionmentioning

confidence: 99%

Study of Cervical Biopsy over a Decade at a Tertiary Level Hospital, Nepal

Tamrakar

Shrestha

2019

Nep. Med. Coll. J.

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Cervical carcinoma is the most common gynecological malignancy and almost curable cancer, if identified at an early stage. Cervical biopsy remains the ‘gold standard’ for the diagnosis of precancerous cervical lesion. The objective of this study was to review the histopathological findings of cervical biopsy including cervical polypectomy and hysterectomy specimens at Dhulikhel Hospital from January 2008 to December 2018. Out of 2098 cases, almost half of the cases (49.3%) were of Brahmin/Chhetri castes. There were significant differences in mean ages among hysterectomy cases (47.55±9.26), cervical biopsy cases (43.08±11.50) and polypectomy cases (33.59±12.47) (p value < 0.005). Out of 925 cervical specimens (cervical biopsy and polypectomy), colposcopy and hysteroscopy were performed in 18.2% and 12.7%, respectively. Out of 1173 hysterectomies, there were 110 cases (9.4%) of malignancies and cervical cancer was the most common (67, 60.9%). The mean age of cervical cancer patients was 52.87±11.94 years. Cervical cancer detected in age group of 40 – 59 years was significantly high (p value < 0.005). Incidence of cervical cancer was lowest in Brahmin/Chhetris (2.4%) compared to Newars (3.4%) and other Janajatis (12.8%) and the difference was statistically significant (p value < 0.005). The findings of this study is useful in updating the histopathological pattern of cervical biopsies.

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“…2 It is the leading cancer among women in developing countries like Nepal. 3 Contributing factors which increase its prevalence include early marriage, multiple sexual partner, poor nutrition, prostitution, recurrent cervicitis, Human Papiloma Virus (HPV) infection. Late diagnosis at advance stage is difficult to manage.…”

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confidence: 99%

“…Different screening methods are used for the detection like Visual Inspection with Acetic acid (VIA), Visual Inspection with Lugole Iodine (VILI), Pap smear and HPV testing. 3 Pap test is one of the reliable methods of early detection of cervical intraepithelial neoplasia and carcinoma of cervix. It is a sensitive and widely used test for early detection.…”

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confidence: 99%

Cervical Cancer screening in a tertiary care centre by Pap smear and its clinical correlation

Sharma

Adhikari²,

Parajuly³

et al. 2019

Med. J. Pokhara Acad. Health Sci.

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Introduction:Cervical cancer is one of the common cancers in women and is a major public health problem all over the world. It has significant contribution to high mortality and morbidity. Preinvasive lesions spontaneously regress to normal, remain stable for a long time or progress to higher degree of dysplasia followed by carcinoma cervix. Materials And Method This was a hospital based retrospective study where 456 patients' records were reviewed. Pap smear was used as the screening tool for the detection of precancerous lesion among the women visiting Western Regional Hospital (WRH), Department of obstetrics and gynecology. Results: Among 456 patients screened, most of them were in the age group of 30-39 years (42.8%) and were of parity 3 (42.8%). Most of them had no risk factors for carcinoma cervix (54.4%). Early marriage accounted for the highest risk of developing precancerous lesion (32.7%). There were no carcinoma detected by Pap smear. The test was negative in 68.9%, Low-grade Squamous Intraepithelial Lesion (LSIL) was detected in 5.9% and 2.9% had High-grade Squamous Intraepithelial Lesion (HSIL). Pap smear was sent for screening purpose in asymptomatic women (37.1%) and among the symptomatic patients vaginal discharge was the most common indication of pap test (34.6%). Conclusion: A Pap smear is reliable, simple, non-invasive, cost effective, and easy screening tool for detection of precancerous lesions in a woman.

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A Clinical Audit of Pap Smear Test for Screening of Cervical Cancer

Cited by 13 publications

References 8 publications

Cervical pap smear- A prospective study in a tertiary hospital

Cervical pap smear- A prospective study in a tertiary hospital

Study of Cervical Biopsy over a Decade at a Tertiary Level Hospital, Nepal

Cervical Cancer screening in a tertiary care centre by Pap smear and its clinical correlation

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