The Cervical pap smear cytological changes with clinicopathological correlation in a sample of Iraqi patients

Objectives: This study aimed to evaluate the role of Pap test in detecting pre-cancerous lesions in Iraqi women aged 45 years to 85 years, correlate the pap result with patient’s age, parity, number of births, number of abortions, chief complaint, and clinical cervical exam, and to evaluate the diagnostic accuracy of the pap test in correlation to histopathological examination. Methods: Women who attended the outpatient gynaecological clinic of the Department of Obstetrics and Gynaecology at Baghdad medical city, Baghdad, Iraq, from January 2019 to January 2020 who had different chief complaints were selected for the study. Women who are 45 years to 85 years old were included in the study. A Pap smear was used for all women to screen for cervical cancer and the results were reported according to the 2014 Bethesda system. The data analysis was done utilizing statistical package for social sciences version 24 (SPSS v24). Results: Total number of pap smears analyzed were 510, NILM (negative for intraepithelial lesions or malignancy) constituted major group 464/510 (91%) and epithelial cell abnormality were 46/510 (9%), age is significantly correlated with increasing rate of pre-neoplastic and neoplastic lesions in women and the significance of vaginal discharge & postmenopausal bleeding and its association with premalignant changes in the cervix. The sensitivity of Pap test is 94%, the Specificity was 60% and accuracy rate 74%. Conclusion: There is significant correlation between Pap smear abnormality and increasing age, vaginal discharge and postmenopausal bleeding, were evident in this study.

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Knowledge, Attitude, Practice and Barriers regarding cervical cancer and its screening using Pap smear, in rural women of Ba, Lautoka and Nadi, Fiji.

Pacific Journal of Reproductive Health ◽

10.18313/pjrh.2015.913 ◽

2015 ◽

Vol 1 (2) ◽

pp. 50 ◽

Cited By ~ 1

Author(s):

Swaran Naidu ◽

Gillian Heller ◽

George Qalomaiwasa ◽

Sheetal Naidu ◽

Rajat Gyaneshwar

Keyword(s):

Risk Factors ◽

Cervical Cancer ◽

Rural Women ◽

Pap Smear ◽

Age Groups ◽

Pap Test ◽

High Rate ◽

Pap Smears ◽

Screening Programs ◽

Lack Of Knowledge

Background: Fiji has a high rate of cervical cancer, which is the second most common cause of cancer deaths in women in the country. Less than 10% of women are screened for cervical cancer in Fiji.In this paper we report the result of a study on Knowledge, Attitude, Practice and Barriers (KAPB) to cervical cancer and its screening with Pap smears, conducted on 1505 rural women in Fiji.Objectives: To assess the knowledge, attitudes, practice and barriers to cervical cancer and it’s screening with Pap smears in rural women of Ba, Lautoka and Nadi, in Fiji.Methods: Structured questionnaires were administered to women presenting to a rural outreach Reproductive Health education and clinics, by trained health educators to ascertain their Knowledge, Attitudes, Practice and Barriers to cervical cancer and its screening with Pap smears.Results: Seventy two percent of rural women had no knowledge of cervical cancer and 80% had no knowledge of the risk factors of cervical cancer. Lack of knowledge was significantly different for age groups (p=0.006), education levels and employment status(p<0.001) and ethnicity (p=0.022). Those groups with lowest knowledge were teenagers (18 to 19 years); those with less education; and iTaukei respondents. Of the respondents who had at least some knowledge of the Pap smear, 75% had had a Pap test. Of those who had no knowledge of the Pap smear, only 45% had had the test (p<0.001). Of those who did not have a Pap smear the commonest barrier was lack of knowledge at 46.3% and fear of procedure was 29.4%.Conclusion: More education is required to acquaint women in rural Fiji about cervical cancer, its associated risk factors as well as the benefits of cervical cancer screening programs and other prevention strategies.

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An Audit of Pap Smear Cytology

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1146 ◽

2011 ◽

Vol 3 (3) ◽

pp. 121-124 ◽

Cited By ~ 1

Author(s):

Harendra Kumar ◽

Aparna Narasimha ◽

B Vasavi ◽

M Sapna

Keyword(s):

Pap Smear ◽

Pap Test ◽

High Standard ◽

Poor Quality ◽

Pap Smears ◽

Sampling Errors ◽

Significant Discrepancy ◽

Cervical Cancers ◽

Atypical Cells

ABSTRACT Introduction Cervicovaginal cytology (Pap test) is the commonly used tool for screening of cervical cancers. Its accurate interpretation depends on obtaining adequately cellular samples prepared to a high standard. Its accuracy and cost-effectiveness can be seriously compromised by inadequate samples. Aim To audit the adequacy of Pap smears in diagnosing cervical cancer. Study design Pap smears reported were retrieved from the hospital records and data were analyzed. Histopathology correlation done for abnormal pap smears. Results A total of 1,531 cases were reported; 1,157 (75.57%) cases were adequate and 374 (24.42%) inadequate. Qualitative inadequacy included inadequate fixation and poor quality of staining 10 (2.67%), drying artefacts 15 (4.10%), broken slides five (1.33%). Quantitative inadequacy was sampling errors — lack of junctional component 186 (49.73%), presence of inflammation 138 (36.89%) and blood 20 (5.34%). 998 (86.25%) were labeled as negative. About 159 (13.74%) cases showed epithelial cell abnormalities. Cytohistological correlation revealed significant discrepancy. The majority of these were carcinomas that were misdiagnosed as atypical cells. Conclusion Cytopathologists or clinicians must be adequately trained, experienced and subject to regular audit. Reporting of atypical cells needs to be addressed with more stringent training of cytopathologists.

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What are Women Told about Pap Smears That Lack Endocervical Cells?

Journal of Medical Screening ◽

10.1177/096914139500200211 ◽

1995 ◽

Vol 2 (2) ◽

pp. 105-108 ◽

Cited By ~ 1

Author(s):

Margot J Schofield ◽

Julie E Byles ◽

Rob Sanson-Fisher

Keyword(s):

Pap Smear ◽

New South ◽

New South Wales ◽

Pap Test ◽

Screening Tests ◽

Pap Smears ◽

Test Results ◽

South Wales ◽

Definition Of ◽

Test Result

Background — Debate exists about the definition of what constitutes an adequate Pap smear and about the recommended rescreening interval for Pap smears lacking an endocervical component. This study aimed at determining whether women are currently informed about the endocervical status of their Pap smears and what rescreening recommendations are made to women whose smears lack endocervical cells. Method — Consecutive Pap smears lacking an endocervical component were identified from pathology records. After obtaining consent from the referring doctor, 165 women were interviewed by telephone. Results — Only 110 (67%) of 165 women received active notification of their Pap test result and only six (4%) were aware that their smear lacked endocervical cells. Thirteen (8%) had been advised to have a repeat smear within three months. Nearly half the women reported that they would like more information about their result. Conclusions — It seems that current Pap smear notification patterns for women in New South Wales could be improved. One third are not actively informed at all about their results, and few are given detailed information about their Pap test results. Methods of enhancing the level of information women are given about their medical and screening tests need to be improved.

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STUDY AND ANALYSIS OF CERVICAL PAP SMEARS IN A MEDICAL COLLEGE HOSPITAL

10.36106/gjra/5301080 ◽

2021 ◽

pp. 31-33

Author(s):

S. Preetika ◽

Sahayaraj Sahayaraj

Keyword(s):

Cervical Cancer ◽

Pap Smear ◽

Age Groups ◽

Pap Test ◽

Developed Countries ◽

Pap Smears ◽

Cervical Lesions ◽

College Hospital ◽

Medical College ◽

Pap Smear Screening

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.

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Comparative study of pap smear and microbiological pattern in bacterial vaginosis

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180888 ◽

2018 ◽

Vol 7 (3) ◽

pp. 1039

Author(s):

Girishma J. ◽

Rupakala B. M. ◽

Sunil Chavan

Keyword(s):

Bacterial Vaginosis ◽

Vaginal Discharge ◽

Pap Smear ◽

Reproductive Age ◽

Gardnerella Vaginalis ◽

Pap Smears ◽

Gram Stain ◽

Medical College ◽

Gram Staining ◽

Gynecology And Obstetrics

Background: Bacterial vaginosis is the most common cause of vaginal discharge among women in reproductive age group. It is characterized by an increased vaginal pH and loss of normal lactobacilli and overgrowth of anaerobes like Gardnerella vaginalis and other gram-negative rods. Purpose of this study is to compare the characteristics of pap smear and microbiological pattern in patients with abnormal vaginal discharge.Methods: The study was conducted in the Department of Gynecology and Obstetrics of Rajarajeswari Medical College and Hospital (RRMCH) Bangalore, India. All patients with vaginal discharge were included in the study. Vaginal discharge samples were sent to gram staining, culture and pap smear examination.Results: Of the 52 patients, 18 patients (34.6%) showed positive for bacterial vaginosis according to Nugent’s score. Of the 18 patients with positive Gram stains, 8 of them were positive for bacterial vaginosis according to pap’s smear (44%) and 10 had negative pap smears. In our study, of the 18 patients with positive Gram stains, 14 (77%) of them were positive for bacterial vaginosis according to culture.Conclusions: In the present study we found out that correlation of gram stain and pap smear was 44% whereas correlation of gram stain and culture was 77%. Hence, we conclude that gram stain and culture are preferred for the diagnosis of bacterial vaginosis rather than the pap smear evaluation.

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A comparative study to see the effectiveness of Pap smear, visual inspection with 3-5% acetic acid and its confirmation by cervical biopsy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20200365 ◽

2020 ◽

Vol 9 (2) ◽

pp. 715

Author(s):

Mili D. Choudhury ◽

Sivaji S. Ghose ◽

Milind Y. Dharmamer

Keyword(s):

Acetic Acid ◽

False Positive ◽

Visual Inspection ◽

Pap Smear ◽

Histopathological Examination ◽

Single Case ◽

Cost Effective ◽

Pap Smears ◽

Severe Dysplasia ◽

Cervical Biopsy

Background: Cancer of the cervix is a leading cause of morbidity and mortality among women worldwide. The present study was undertaken to compare the effectiveness of Pap smear and visual inspection with 3-5% acetic acid (VIA) in screening carcinoma cervix followed by its confirmation by cervical biopsy.Methods: A total of 100 patients with abnormal looking cervices or symptomatic patients having age beyond 30 years, attending the obstetrics and gynaecology OPD at Naval Hospital Powai, Mumbai from 31st December 2015 to 31st December 2017 were selected for the study. Pap smear and VIA was done on consecutive days. In positive cases cervical biopsy were done to confirm the result.Results: The sensitivity of VIA was 100% but at the same time specificity was 41% there will be unnecessary investigation and biopsy in false positive cases. The sensitivity of cytology was 75% and specificity was 97%. Not a single case was missed by Pap smear only one case of severe dysplasia on cytology had squamous cell carcinoma on HPE which was done after 90 days because of delay in patients follow up.Conclusions: Both the Pap smears and VIA is very effective screening tool for cervical cancer and histopathological examination remains the mainstay. But VIA is very cost effective and easy procedure, though it gives false positive reports but is not going to miss any case, rather leads to over diagnosis of the cases with cervicitis and hence treatment starts early and thus the progress of disease can be slowed down or even stopped.

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Pap smear in women with leucorrhea : Experience in a tertiary medical college hospital of Bangladesh

Northern International Medical College Journal ◽

10.3329/nimcj.v9i1.35921 ◽

2018 ◽

Vol 9 (1) ◽

pp. 252-254

Author(s):

Mohammed Mustafizur Rahman ◽

Shabnam Imam ◽

Mst Sayedatun Nessa ◽

Joyosree Saha ◽

Farhana Islam ◽

...

Keyword(s):

Candida Albicans ◽

Vaginal Discharge ◽

Pap Smear ◽

Pap Smears ◽

Low Grade ◽

College Hospital ◽

Medical College ◽

Epithelial Lesions ◽

Genital Hygiene ◽

Epithelial Lesion

Background : Poor genital hygiene has been responsible for high prevalence of excessive vaginal discharge. Leucorrhoea is the clinical evidence of infection and can be treated satisfactorily whenever diagnosed. Occurrence of various cervical epithelial lesion associated with discharge can be easily prevented if detected early. Majority of the patients with various cervical epithelial lesion attending in the hospital present with varying degree of vaginal discharge and cytological cellular aberrations in the cervical epithelium.Objective : The aim of the present study is to observe the various patterns of cervical epithelial lesions in cytopathology and associated infections in patients with Leucorrhoea.Methodology : This observational study was done over a period of ten months in Popular Medical college hospitals of Bangladesh. A total of 230 cases were included in the study with women of age range 15-45 years, complaining of leucorrhoea. After a thorough vaginal examination Pap smears were taken and immediately fixed in absolute alcohol and stained according to the papanicolaous technique. The cytopathological changes observed in the cervical smears were graded according to the Bethesda system for reporting cervical cytology.Results : Out of 230 cases the cytological patterns were found Normal in 4 (1.7%), Inflammatory 204 (88.3%), Low grade squamous intraepithelial (LSIL)10 (4.8%), High grade squamous intraepithelial (HSIL) 6(2.6%), Atypical squamous cells of undetermined significance (ASCUS) 6 (2.6%) and the distribution of different types of pathogens detected were Trichomonas 33 (70.62%), Candida albicans 19 (40.66%).Conclusion : In this study significant numbers of Leucorrhoea patients were detected with cervical squamous intraepithelial lesions (SIL) in which LSIL (Low grade squamous intraepithelial) was higher. Associated infections were Trichomonas and Candida albicans. Therefore cytological screening for early detection of cervical squamous intraepithelial lesion is essential routine medical examination for Leucorrhoea patients in gynaecological practice.Northern International Medical College Journal Vol.9(1) July 2017: 252-254

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Cytomorphometric Analysis of Cervical Papanicolaou Smear for Females with Gynecological Clinical Complaints

International Journal of Biomedicine ◽

10.21103/article11(1)_oa9 ◽

2021 ◽

Vol 11 (1) ◽

pp. 46-49

Author(s):

Sahar Osman ◽

Ehab Elmadenah ◽

Osman Elmahi ◽

Mubarak Alkarsani ◽

Lienda Eltayeb ◽

...

Keyword(s):

Pap Smear ◽

Screening Program ◽

Age Groups ◽

Pap Test ◽

Optical Microscope ◽

Pap Smears ◽

Age Group ◽

Limited Information ◽

Gynecological Diseases ◽

A Prospective Study

Background: Limited information is provided on the quantitative cytomorphometric study of the cervical Pap test. The cervical Pap test is an important screening program for cervical cancer. A quantitative cytomorphometric examination of cervical Pap is used to accurately identify precancerous and cancerous lesions early and to reduce the occurrence and avoidance of invasive cancer. This study was aimed to assess the cytomorphological parameters (nuclear diameter [ND], cytoplasm diameter [CD], and nuclear-to-cytoplasmic ratio [N/C ratio]) of squamous epithelial cells from a cervical Pap smear. Methods and Results: A prospective study was performed on 142 consecutive cervical Pap smears from women with gynecological clinical complaints. The ND and CD were determined by the Optika optical microscope camera using a digitizer cursor in both axes. The final images were taken with an X40 magnification. The ND, CD, and the N/C ratio were then measured and expressed in micrometers. The women were classified into 5 age groups: 5(3.5%) in the age group of <19 years, 46(32%) in the 20-29 group, 67(47.2%) in the 30-39 group, 23(16.2%) in the 40-49 group, and 1(0.7%) woman was over age 50. There were no significant differences in the N/C ratio of superficial cells between age groups. The ND, CD, and the N/C ratio were significantly higher in women with clinical complaints than in women without clinical complaints Conclusion: Cytomorphometic analysis might assist in the identification of cellular alterations due to gynecological diseases and increase the sensitivity and accuracy of the Pap smear technique.

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Cytological pattern of cervical pap smears

Journal of Pathology of Nepal ◽

10.3126/jpn.v8i1.19454 ◽

2018 ◽

Vol 8 (1) ◽

pp. 1280-1284

Author(s):

Rashmey Gurung Pun ◽

Jashmine Shrestha ◽

Pankaj Joshi Awale ◽

Neershova Chitrakar ◽

Rupa Jha ◽

...

Keyword(s):

Epithelial Cells ◽

Pap Smear ◽

Screening Method ◽

Pap Test ◽

Pap Smears ◽

Common Etiology ◽

Common Technique ◽

Intraepithelial Lesion ◽

Bethesda System

Background: Cervical cancer is one of the leading causes of morbidity and mortality. It can be preventable and diagnosed early with adequate and repetitive cytological screening by pap test. The conventional cervical cytological screening is the most common technique used throughout the world.Materials and Methods: The present study is a retrospective study, carried out at Kantipur Dental College, Lagankhel polyclinic, Nivarak polyclinic and Grande city clinic and hospital services. Total 1999 cases were screened in two years period from shrawan 2072 to shrawan 2074.Results: Out of 1999 smears, 56 cases (2.8%) were unsatisfactory/inadequate, 1884 (94.25%) smears were negative for intraepithelial lesion/malignancy, 115 (5.75%) smears showed epithelial cells abnormalities and 439(21.96%) smears were with reactive cellular changes associated with inflammation. Bacterial vaginosis (55.35%) was the most common etiology identified in 439 cases inflammatory smears. Total 310 (15.5%) cases showed moderate to severe atrophic changes in smear cytology. Among 18 follow up cases of carcinoma cervix, one case (0.2%) was identified as relapse case.Conclusion: Bethesda system classification 2001found to be very useful screening method for early detection of epithelial cells abnormalities of cervix in nepali population. As all the cases of epithelial cells abnormities were of age above 30 years, Pap smear examination should begin in women at least at the age of 30 years. Large studies are required to estimate the pattern of cervical cytological abnormalities along with Human papilloma virus (HPV) strain detection in Nepalese population.

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Cytological versus Histopathological Examination in Lesions of Cervix, taking histopathology as a Gold Standard

10.53350/pjmhs211561404 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1404-1406

Author(s):

A. Ilyas ◽

A. U. Rehman ◽

M. Ikram ◽

G. A. Khan ◽

M. J. Khan ◽

...

Keyword(s):

Predictive Value ◽

Pap Smear ◽

Histopathological Examination ◽

Pap Smears ◽

Factors Analysis ◽

Specificity And Sensitivity ◽

Golden Standard ◽

Bethesda System ◽

Epithelial Lesions

Background: Malignancy of cervix is the major health burden in South Asia including Pakistan. PAP smear is the screening test for its early detection. To find out the specificity and sensitivity of the system called as Bethesda system, the correlation of cytological findings with histopathology,with histopathological examination as the golden standard. Aim: To find out the cytological utility in diagnosing different pathologies of cervix, to assess and infer the epithelial lesions cases and to correlate cytology findings with its consequent follow-up biopsies. Methods: This study was carried out taking 150 PAP smears of women coming to gynecological OPD ofShaikh Zayed Hospital Lahore from September 2020 to February 2021. There correlation with subsequent follow-up histology sections by using 2001 revised Bethesda System.Different factors analysis which were causing inconsistencies was done. Results:The overall sensitivity of PAP smear is 86.94%, specificity 57.14%, positive predictive value 86.94 %, negative predictive value 57.14 % and accuracy 80% in detecting low/high grade lesions and malignancy. Keywords: Bethesda system,Cervix cytology findings; Histopathological findings.

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