The Correlation of Papanicolaou Smears and Clinical Features to Identify the Common Risk Factors for Cervical Cancer: a Retrospective and Descriptive Study From a Tertiary Care Hospital in Trinidad

Abstract

Background: Cervical cancer, the fourth most frequent cancer in women, is associated with the human papilloma virus (HPV). This study focuses on identifying any risk factors and clinical findings for abnormal cervical cytology and histopathology in relation to the Trinidad and Tobago population. Some risk factors include early age of first coitus, high number of sexual partners, high parity, smoking, and use of certain medications such as oral contraception. This study is aimed to identify the significance of Papanicolaou (pap) smears and to identify the common risk factors that contribute to the development of premalignant and malignant cervical lesions. Method: A three-year retrospective, descriptive study of cervical cancer was conducted at the Eric Williams Medical Sciences Complex to assess the risk factors and clinical findings using cervical cytology and histopathology data of patients with premalignant lesions. The subject population included 215 female patients aged 18 years and older who had the following documented abnormal cervical cytology: (ASCUS), ASC-H, LSIL, HSIL, Atypical Glandular cells, HPV, Adenocarcinoma, Invasive Squamous Cell Carcinoma. Histopathology records were analysed for thirty-three of these patients. Patients’ information were recorded on data collection sheets adapted from the North Central Regional Health Authority’s cytology laboratory standardised reporting format request form (Appendix I). Results and findings: The data were analysed via Statistical Package for Social Sciences (SPSS) software edition 23 using frequency tables and descriptive analysis. The sample mean age of the population was 36.7 years, first age of coitus was 18.1 years, number of sexual partners was 3.8 and number of live births was 2. LSIL was the most popular abnormal finding, 32.6 %, followed by HSIL, 28.8% and ASCUS, 27.4%. Most histopathological reports resulted in CIN I and II.Conclusion: The major risk factors observed for cytology abnormalities and premalignant lesions were early age of coitus, high number of sexual partners, and no use of contraception.Patients mostly presented as asymptomatic despite obtaining abnormal cytology results. Hence, regular pap smear screening should continue to be highly encouraged.