scholarly journals Colposcopic evaluation of cervix with abnormal papsmear findings: prospective analytical study at our tertiary care centre

Author(s):  
Bhawna Verma ◽  
Radha Rastogi ◽  
Dipti Srivastava ◽  
Saroj Saharan

Background: Pap test has been successful in reducing the incidence of cervical cancer by 80% and mortality by 70%. Any women with a cytologic specimen suggesting the presence of HSIL on Pap smear should undergo colposcopy and dissected biopsy. Prevention of invasive cancer by early detection and treatment of cervical intraepithelial neoplasia (CIN) currently offers the most cost effective, long term strategy for cervical cancer control. The aim of study was to minimise disagreements and make colposcopy assessment quick, accurate and easy for follow-up.Methods: Prospective analytical study of 300 gynaecological patients with abdominal Pap smear findings between June 2020 to Dec 2020 at R.N.T. Medical College, Udaipur. All of them were subjected to colposcopy and dissected biopsy from the abdominal areas. The incidence of CIN/invasive carcinoma was calculated by proportion/percentage.Results: Incidence of invasive carcinoma was <1% but the incidence of premalignant lesion CIN was high (20.9%), CIN 2/3 and CIS were present in 6.9%.Conclusions: Patients with persistent inflammation pap smear can harbour high proportion of CIN and hence these patients need further evaluation through colposcopy.

Author(s):  
Mehak Reyaz ◽  
Nupur Nandi ◽  
Ritika Aggarwal

Background: Cervical cancer is the fourth most common cancer in women. In India and other developing countries cervical cancer is the leading cause of morbidity and mortality. Cancer cervix continues to be most common genital carcinoma in India accounting for 80% of all female genital malignancies. Pre-invase lesions can spontaneously regress to normal or remain stable for long period or progress to a higher degree of dysplasia. Cancer of cervix is preventable if diagnosed at the pre-invasive stage with regular intervals of cytological screening by Papanicolaou (Pap) smears. The aim of the study is to analyse the pap reports in terms of normal findings, infections, premalignant lesions and invasive cancers.Methods: All women attending the outpatient department gynaecology at TMMC and RC Moradabad, Uttar Pradesh over a period of 1 year from august 2017-18 presented of obstetrics and with white discharge per vagina were screened for cervical cancer using pap smear. All the smears were reported as per the 2014 Bethesda system.Results: Out of 1392 Pap smear reports ASCUS was reported in 27 cases (2%), LSIL in 27 cases (2%), HSIL in 15 cases (1%), malignant cells in 15 cases (1%) and normal including the infection is reported in 1308 cases (94%).Conclusions: Early cervical epithelial changes can be identified by a Pap smear test, which is the primary screening test for detection of precancerous cervical intraepithelial neoplasia and the early stage of invasive cervical cancer.


2016 ◽  
Author(s):  
Astha Srivastava ◽  
Bindiya Gupta ◽  
Vikas Lakha ◽  
Shilpa Singh

Objective: To study the knowledge, attitude and practice of nurses at tertiary centre regarding cervical cancer screening. Material and Methods: Validated questionnaire was circulated amongst staff nurses at tertiary care centre after taking informed consent. Results and Discussion: Cancer of cervix is the most common genital tract malignancy in female and it is ranked second to breast cancer. It has a positive association with HPV infection. Cervical cancer incidence and mortality have declined substantially following introduction of screening programmes. This present study investigated the knowledge, attitude and practice of nurses at GTB Hospital towards cervical cancer risk factors, sign & symptoms and screening as they are important health professionals. In our study, the results showed that 99% of respondents were aware of Pap smear as screening programme and about 60-70% were aware of HPV as positive organism, but most of them never had a Pap smear done before. Majority of them did not know VIA, VILI and colposcopy as screening techniques. Conclusion: It may thus be recommended that institutions should periodically organize seminars and training for health personnel especially the nurses which form a group of professionals that should give health education to women about cervical cancer.


2021 ◽  
Vol 7 (1) ◽  
pp. 33-39
Author(s):  
Dr. N. Thamarai Selvi ◽  
◽  
Dr. Revathi Shree R ◽  
Dr. Prakashiny S. ◽  
◽  
...  

Introduction: Carcinoma Cervix is common all around the globe and ranked third amidst allmalignancies among women. The cervical mucosa undergoes morphologic variation with age andpractising cytopathologists is aware of these difference to make an accurate diagnosis. This studyaimed to detect abnormal cervical epithelial cell patterns in a rural population and compare lesionsor abnormal cell patterns among different age groups. Materials and Methods: This is a cross-sectional, descriptive study conducted in a tertiary care centre at the Department of Pathology over6 months. 408 women were included in the study. Data were entered in Microsoft Excel andanalyzed in SPSS software. Results: Out of 408 women included in the study, the most commonage group of the presentation was 31 to 40 years (36%), followed by 20 to 30 years (24%). NILM-Inflammatory was the most common finding (50%), followed by NILM (36%). The most commonsymptoms of presentation were Menstrual abnormalities (21%), White discharge and pruritus(18%). Findings in younger women were most commonly NILM-Inflammatory & NILM whereas in thepost-menopausal age group, ASCUS, LSIL & HSIL. Conclusion: All women above 30 years of ageshould undergo routine cervical cancer screening, and should continue screening even in theperimenopausal and postmenopausal age. Most women who visited the gynaecology OPD were notaware of cervical cancer screening. Hence the general population has to be educated about thebenefits of pap smear test through medical camps and awareness programs.


2017 ◽  
Vol 4 (3) ◽  
pp. 799
Author(s):  
Richa Garg ◽  
Ranjana Desai

Background: Cervical cancer in India ranks as the 2nd most frequent cancer among women and the 2nd most frequent cancer among women between 15 and 44 years of age. Invasive carcinoma of cervix is preventable as it is associated with pre-invasive stage which occurs 10-15 years prior to it, thus permitting early detection by screening and leading to effective treatment and thereby reducing mortality rate with greater impact on lives saved. Objectives were to correlate the findings of Pap smear with colposcopy in evaluation of all symptomatic women; and to assess the utility of colposcopy in detecting the premalignant and malignant lesions of cervix.Methods: This was a prospective observational study of 200 symptomatic women attending the Gynecology OPD of Umaid Hospital Dr. S. N. Medical College Jodhpur, Rajasthan, India from February 2015 to October 2016. Evaluation of all symptomatic women done with Pap smear, colposcopy and biopsy in selected cases and findings were noted.Results: Commonest complaint was white discharge per vaginum in 58.5% followed by pelvic pain in 24% women. 8% women had abnormal pap smear findings with 4% of women had ASCUS, 0.5% had ASC-H, 3% had LSIL and 0.5% had HSIL,73% had inflammatory and 19% with normal smear. 38.5% had abnormal colposcopy with maximum 28% women had acetowhite lesions. Sensitivity of pap smear was 44.44% while sensitivity of colposcopy was 88.88%.Conclusions: Pap smear had poor sensitivity as compared to colposcopy. Hence simultaneous use of colposcopy has shown to increase in the rate of carcinoma cervix detection in symptomatic women.


Author(s):  
Mohammad Khushnood ◽  
Priya Vijaykumar Gameti ◽  
Anisha Rajani ◽  
Mala Jain

Background: Mortality due to cervical cancer is also an indicator of health inequalities, as 86% of all deaths due to cervical cancer are in developing countries, low- and middle-income countries. Though Pap smear is a routine screening test, the overall sensitivity in detection of high grade squamous intraepithelial lesion (HSIL) is 70 - 80% .Pap smear is a simple, safe, non-invasive and cost effective method for the detection of pre-cancerous, cancerous and benign lesions of cervix. Materials and Method: Around 100 cases attending gynecology OPD consented to participate were selected between age 15-60years with complaints. Pap smear was taken and was reported by cytopathologists according to the 2001 Bethesda system. All the data were manually collected and subsequently analyzed.   Results: Maximum number of cases (37%)were seen in the age group og 31-40 years followed by 41-50 years (29%)and rest between 21-30 years (26%). 8% cases were seen in the age group of 51-60 years. NILM was reported in 48% of cases. Inflammatory smears were seen in 44% of cases. Two smears were reported as unsatisfactory.02% of cases was reported as ASCUS.LSIL was reported in 02% of cases while HSIL were reported in 01% of cases. Non specific findings were reported in 01 case. Conclusion: This study proves that PAP stain is a simple, cheap, inexpensive and easy procedure and that using PAP stain cytological screening programs conducted in developing countries can play a major role in reducing mortality and morbidity due to Cancer Cervix. Keywords: PAP stain, Cervix, Cancer


CytoJournal ◽  
2010 ◽  
Vol 7 ◽  
pp. 16 ◽  
Author(s):  
Papa Dasari ◽  
S Rajathi ◽  
Surendra V Kumar

Background: Inflammatory Pap smear is the most common report received by a gynecologist. The cervical screening algorithm for benign cellular changes on the Pap smear recommends treatment of infection if indicated and a repeat Pap smear in 4 to 6 months time. If the inflammatory changes still persist, subject the patient to colposcopy. However, in practice, this is not followed, especially in developing countries like ours where proper screening protocols are not available. Hence, a good number of patients in the premalignant stage are being missed. This study was undertaken to evaluate patients with persistent inflammatory Pap smears without atypia using colposcopy. Methods: A prospective analytical study of 150 gynecologial patients with persistent inflammatory Pap smear between 2006 and 2008 in an out-patient setting. All of them were subjected to colposcopy and biopsy from the abnormal areas. The incidence of cervical intraepithelial neoplasia (CIN)/invasive carcinoma was calculated by proportions/percentages. Results: The incidence of invasive carcinoma was <1%. But, the incidence of pre-malignant lesions (CIN) was high (20.9%). CIN 2/3 and carcinoma in situ were present in 6.9% of the cases. Conclusions: Patients with persistent inflammatory Pap smears can harbour a high proportion of CIN and hence these patients will need further evaluation.


Author(s):  
Vidya A. Thobbi ◽  
Farheen Khan

Background: The present hospital-based study was conducted to study the incidence of various cervical epithelial abnormalities such as infection, dysplasia and early cervical cancer changes in reproductive age population and its correlation with age, parity, socioeconomic status, clinical symptoms and cervical biopsy findings.Methods: A prospective study was conducted in 300 women of reproductive age group. The cervical smear was taken from all patients by means of the scrape technique using the Ayre’s spatula. Pap smear results were considered as positive (abnormal) when they are ASCUS, LSIL, HSIL or Invasive lesion. On persistence of unhealthy cervix/inflammatory smear after a course of antibiotic, direct cervical punch biopsy was taken.Results: Inflammatory smears were seen in 88.0%, ASCUS in 5%, LSIL in 1.4%, HSIL in 0.3% and invasive carcinoma in 0.3% patients. Direct cervical punch biopsy was taken from 13 cases out of 264 with inflammatory smear. Most of these patients had cervicitis (12 cases) while 1 case showed CIN stage 2. All cases of ASCUS and LSIL had infection which showed chronic cervicitis on biopsy. HSIL and Invasive carcinoma showed CIN stage 2 and Carcinoma as their biopsy findings.Conclusions: The Pap smear is a simple, safe, practical and cost-effective method for early detection of cervical cancer and its precursors. In developing countries like India, it is the most logical screening modality although it has a very low sensitivity, but detection rates could be further improved using liquid-based cytology and the use of endocervical cytobrush.


Author(s):  
Kriti Bhatnagar ◽  
Kalpana Baghel

Background: Cervical cancer is one of the biggest health problems of women around the world. An estimated 4,70,000 new cases are diagnosed worldwide annually with about 80% of these being in developing countries with India contributing to about a quarter of it. Pap smear and colposcopy are two non-invasive methods for screening of cervical cancer with varying sensitivity and specificity. This study uses these along with histopathology to find out premalignant lesions in women of rural western Uttar Pradesh, India and to find their correlation with various socio-demographic features.Methods: This prospective clinical study was carried out in department of Obstetrics and Gynaecology in Muzaffarnagar Medical College from 1st January 2012 to 31st December 2014. Those patients who fulfilled the inclusion criteria had their Pap smear done at first visit followed by colposcopy when cytology report was available. Colposcopically indicated biopsy was done only in those patients who had suspicious areas on colposcopy.Results: Out of total 500 women included in the study majority although having a bad cervix were having a normal pap smear (45%). LSIL and HSIL were present in 17.4% and 9.8% respectively. Squamous metaplasia was the most common abnormal finding seen in 12.2% of cases followed by acetowhite areas (7.6%). Only 137 patients who had abnormal colposcopic findings were subjected to biopsy.Conclusions: In present study it was found that increasing age, early age at coitarche and high parity are risk factors for high grade lesions. Colposcopy served as a tool to decrease the need for invasive procedure i.e biopsy.


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