Significance of inflammation in cervical cytology smears in rural women of India: An observational study

Abstract

Introduction: Inflammatory smears are frequently seen in cervical cancer screening and they have been widely implicated as precursor of premalignancy of cervix. In the present study, attempt has been made to find out correlation between inflammation and different predisposing factors to cervical carcinogenesis in the rural context. Materials and Methods: Cervical cancer screening is in progress in the rural population of West Lucknow, India since May 2013 under the auspices of Era's Lucknow Medical College and Hospital, Lucknow, India and till March 2018, cervical smears of 2563 women have been cytologically examined. Results: The incidence of inflammation was found to be 33.7% in the present series. It was non-specific in 91.3% and was associated with either Candida albicans or Trichomonas vaginalis in 8.2% of cases. The inflammation was associated with low grade squamous intraepithelial lesions of cervix (LSIL) in 176 cases (20.1%) which were mostly asymptomatic (36.1%) and some had cervical lesions on the cervix (11.2%). The inflammatory smears were mostly seen in women complaining of vaginal discharge (47.1%) or vague pain in the lower abdomen (31.9%). The inflammation was more common in younger sexually active women between 21-40 years and was seen rising with increasing parity. Conclusion:The accumulated data points out that the clinical lesions of cervix and multiparity have some impact in the initiation of inflammatory changes in the cervical epithelium. The inflammatory smears, whenever, reported should be adequately treated and smears are repeated after 6 months to rule out any persistence of inflammation or development of any premalignancy.