scholarly journals Utility of Papanicolaou’s smears in the diagnosis of premalignant and malignant lesions of the cervix in a tertiary care centre of South Gujarat, India

Author(s):  
Shivangi S. Gandhi ◽  
Pinal C. Shah

Background: "Preventable but not prevented", this is the reality of cervical cancer today, at least in developing countries. 80% of all the cases of cervical cancer occur in these developing countries. In India, cervical cancer is the leading cause of cancer related deaths in women. The Papanicolaou test is simple, quick, and painless. It is capable of detecting cervical cancer at an early stage and is used widely in developed countries, where it has decreased both the incidence and mortality of cervical cancer. Objective of the study was conducted to determine the importance of conventional Pap smears for the diagnosis of inflammatory, premalignant and malignant lesions of the cervix.Methods: This cross-sectional study was conducted from January 2017 to June 2018 on 2000 women coming for a Pap smear examination in Government Medical College attached to New Civil Hospital, Surat. After doing Pap stain, all cases were reported as per the 2014 Bethesda system.Results: A total of 2000 cases of Pap smears were received out of which 1914(95.7%) cases were satisfactory for evaluation, 86(4.3%) cases were unsatisfactory. The frequency of epithelial abnormalities was 3.66%. The age group of 51-60 years showed the highest epithelial abnormalities. The frequency of epithelial abnormalities in asymptomatic women was 2.3%. Out of the 1844 cases, 103(5.6%) showed changes of atrophy, 1011(54.8%) cases showed inflammatory/reactive changes, whereas organisms were seen in 558(30.3%) cases.Conclusions: Pap smear happens to be an economical, safe and pragmatic diagnostic tool for early detection of cervical cancer.

Author(s):  
Ruksana Farooq ◽  
Azhar-un-Nisa Quraishi ◽  
Shahida Mohammad

Background: Cervical cancer is the most common genital cancer in India. In India alone,almost,130000 new cases occur with the death toll of 70000 everywhere. Objective of current study was correlation of pap smear with histopathological diagnosis.Methods: A retrospective study was conducted in tertiary care hospital in 130 sexually active women. Pap smears were taken and histopathological diagnosis was performed in all such patientsResults: From pap smear findings, out of 130 patients, maximum number of cases, 74 (56.9%) were categorized as. Out of epithelial cell abnormality, ASCUS was seen in 25 patients (10.2%), LSIL in 17 patients (13.1%), HSIL in 11 patients (8.5%). SCC was seen in 2 patients (1.5%) and adenocarcinoma in 1 patient (0.8%). From cervical biopsy reports, 51 cases(39.2%) were diagnosed as chronic cervicitis, 34 cases (26.2%) were diagnosed as chronic cervicitis with squamous metaplasia, CIN I in 31 patients (23.8%), CIN II in 8 patients (6.2%) and CIN III in 3 patients (2.3%), squamous cell carcinoma in 2 patients (1.5%) and adenocarcinoma in 1 patient (0.8%). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of pap smear test was 91.1%, 82.4%,73.2%, 94.6% and 85.4%, respectively.Conclusions: Pap smear has excellent correlation with histopathological diagnosis. Therefore it should be encouraged as effective tool for cervical cancer screening program to reduce incidence and mortality caused by cervical cancer. 


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.


2019 ◽  
Vol 4 (1) ◽  
pp. 2-8
Author(s):  
Pragya Gautam Ghimire ◽  
Durga BC Rawat ◽  
Kavita Sinha ◽  
Kamar Jahan ◽  
Richa Shrestha

Introduction: Cervical cancer is a common health problem in Nepal. There is paucity of data regarding the spectrum of findings in cervical Pap in western Nepal. This study was aimed to study the cytological patterns in cervical Pap smears in patients in a tertiary hospital of Nepal. Methods: This is a prospective, cross sectional, hospital based study. Clinical features of patients who had presented with Pap smear was noted in a structured proforma. Pap smears were studied by a senior pathologist and reported based on revised Bethesda system (2014). Results: Most of the cases belonged to 31-40 years 399 (42.8%). Unsatisfactory/ inadequate sample was present in 133(14.05%) with obscuration due to inflammatory exudate being most common cause. Negative for intraepithelial lesion or malignancy rate was noted in 798 (85.54%) with 477(51.2%) being normal findings. Epithelial cell abnormalities were noted in 116 (14.5 %) smears. Low-grade squamous intraepithelial lesion constituted 321(34.5%), High grade squamous intraepithelial lesion 273(29.3 %) and Atypical squamous cells of undetermined significance 153(16.4%) of epithelial cell abnormalities. Squamous cell carcinoma was present in 9(1%) of all reviewed smears. There was no statistical significance between the age and abnormalities of Pap smear (p=0.9). Conclusions: Pap smear is pivotal in cervical cancer screening in developing countries. It also identifies various inflammatory, infective, benign and malignant pathologies at the earliest thereby decreasing the morbidity and mortality.


Author(s):  
Seema Gupta ◽  
Deepali Jain ◽  
Shweta Khandelwal

Background: Cancer of the cervix is an increasing health problem and an important cause of mortality in women worldwide. The incidence of cervical cancer arises worldwide. Methods: A retrospective study was conducted in the Department of Pathology, JLN Medical College & Hospital Ajmer. Results: A total of 100 smears were analyzed. Out of which 96.00% smears were satisfactory for evaluation.  Out  of 96.00% satisfactory smears, 30.00% shows normal smear and 52.00% shows benign cellular changes and 4.00% shows epithelial cells abnormality. 5.00% smears shows Bacterial vaginosis. 45.00% were inflammatory smears. Conclusion: We concluded that cervical cytology by Pap smear is a simple, safe and effective test to detect premalignant and malignant lesions of cervix at an early stage, and thus help the clinicians in early and more efficient management of the patients. Keywords: Pap smear, Cervix, Cytology.


2021 ◽  
pp. 31-33
Author(s):  
S. Preetika ◽  
Sahayaraj Sahayaraj

Introduction: Cervical cancer is the second most common gynaecological cancer worldwide and the third leading cause of cancer-related mortality in the less developed countries. Cervical cancer may be prevented or diagnosed at early stages due to the easy accessibility and clinical evaluation of the cervix. A pap test is a simple, easy, painless procedure which can be carried out as an outpatient procedure to detect specic, nonspecic inammations, precancerous and cancerous lesions In our study we have analysed the results of PAP smears of women in all age groups and have tried to evaluate the prevalence of cervical lesions and the importance of cervical cancer screening. Material And Methods: Our study was conducted between October 2020 to JULY 2021 and patients who have visited the Gynaec OP during this period were included for this study. We received Pap smears from the Department of Obstetrics and Gynecology, stained the slides with Pap stain and studied the smears according to the new Bethesda System for Reporting Cervical Cytology 2014. Results: In our study, majority of the patients were in the age group of 41-50 years. Smears showing ASCUS were 14 , LSIL reports were 5, HSIL reports were 4. No Smears showed squamous cell carcinoma in our study. Reports in our study like many other studies has shown the importance of Pap smear test in screening cervical cancer. By conducting health camps, increasing health awareness and performing Pap smear screening programmes the incidence of cervical carcinoma can be decreased.


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


2021 ◽  
Vol 12 (8) ◽  
pp. 144-148
Author(s):  
Anil Kumar Sirasagi ◽  
Arpitha K ◽  
Saara Neha ◽  
Pratima Manohar Pattar

Background: Cervical cancer in women is the second most common cancer and the commonest cause of mortality in developing countries. The introduction of Pap smear test changed the scenario of cervical cancer with an intense drop in the incidence and mortality due to invasive cervical cancer. Aims and Objective: To evaluate the patterns of cervical smear cytology and to correlate the cervical smear diagnosis with histopathological diagnosis and to assess the efficacy of Pap smears in diagnosing cervical lesions. Materials and Methods: This two-year retrospective study (January 2018 to December 2019) was done in the department of Pathology in a tertiary care hospital. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated considering histopathological diagnosis of cervical biopsy as the gold standard. Results: A total of 316 Pap smears were studied, out of which we selected 154 cases who also undergone biopsy or hysterectomy. Epithelial cell abnormalities (ECA) were found in 28 cases (18.2%). Among this the most common ECA was Atypical squamous cells of undetermined significance (ASCUS) seen in 10 cases (6.5%) followed by LSIL (5.2%), HSIL (3.2%) and SCC of cervix (3.2%). The overall correlation between cervical cytology and histopathology was found in 125 out of 154 cases (81.16%). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of pap smear was 90.57%, 62.50%, 95.41%, 43.47% and 87.66% respectively. Conclusion: Pap smear is a simple, safe, non-invasive and effective method for detection of lesions of the cervix and ECA. Hence, better awareness and periodical cytological screening programs can help in the early detection of malignant cervical lesions and thereby reducing the morbidity and mortality related to this malignancy.


2016 ◽  
Vol 4 (1) ◽  
pp. 25
Author(s):  
Arantika Meidya Pratiwi

<p>Cervical cancer is a health problem that hit countries in the world. WHO estimates there are 460,000 new cases worldwide and 75% are in developing countries. The incidence of cervical cancer in Indonesia according to the Indonesia Departement of Public Health in 2010 reached 100 per 100,000 population per year. In contrast to the developed countries, the incidence and mortality from cervical cancer has decreased due to cervical cancer screening program that can be done with a pap smear or VIA (Visual Inspection of the Uterine Cervix with Acetic Acid). Based on the results of a survey conducted among women of childbearing age in Sedayu I and II Bantul Local Government Clinic in the last 3 years, it was found that the amount of data women of childbearing age inspecting VIA continues to decrease each year. The aim of research to determine the relationship between a history of getting counseling about VIA and VIA participation in women of childbearing age in Sedayu I and II Bantul Local Government Clinic. This study uses an analytical survey. The design of this study using cross sectional. The population in this study are all of women of childbearing age at Sedayu I and Sedayu II Local Government Clinic. The number of samples taken by counting the estimated number of samples obtained 102 women of childbearing age. The results showed that most of women of childbearing age ever get counseling from midwife/health workers about VIA as many as 65 people (63.7%) and the remaining 37 (36.3%). A total of 60 women of childbearing age (58.8%) has audited women of childbearing age VIA test and 42 (41.2%) have never done VIA test. The conclusion there was signifi cance correlation between a history of getting counseling about VIA and the VIA participation in women of childbearing age in Sedayu I and II Bantul Local Government Clinic with value of p=0.000.</p>


Author(s):  
Meenakshi B. Chauhan ◽  
Sushila Chaudhary ◽  
Sunita Singh ◽  
Manasi Juneja ◽  
Smiti Nanda

Background: Cancer cervix is a leading cause of death among women worldwide. Detection of cervical cancer in precancerous stage is 100% curable. Screening with Pap smear has reduced mortality by cervical cancer in developed countries many folds. The objective of the study is to determine prevalence of Cervical Intraepithelial Neoplasia (CIN) in HIV infected women and observe for associated lower genital infections and their correlation with CD4 counts.Methods: The present study is a cross-sectional observational study conducted at PGIMS, Rohtak, Haryana for a period of 18 months. 150 HIV patients and 150 age related control cases were taken. Pap smears were taken and analyzed for cervical abnormalities and genital infections.Results: Of the 300 Pap smear 22 (7.3%) has squamous intraepithelial abnormalities and 278 (92.7%) negative for intra epithelial abnormalities. Prevalence of cervical intraepithelial abnormities among HIV positive 12% while among HIV negative it is 2.7%. Cervical intraepithelial abnormalities were found in 40% and 3.5% of patients with CD4 count <200 and >200 respectively.Conclusions: HIV increases the risk of cervical abnormalities. Frequent screening of these patients for cervical cancer is needed.


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