scholarly journals Cytological pattern of cervical pap smears

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.

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

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.

scholarly journals Conventional Pap Smear Cytology in a Tertiary Care Center

2021 ◽  
Vol 17 (2) ◽  
pp. 117-123
Author(s):  
Tika Kumari Gurung ◽  
Shree Prasad Adhikari ◽  
Ayushma Adhikari ◽  
Reecha Shrestha ◽  
Chum Maya Pun ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Pap Smear ◽  
Tertiary Care ◽  
Pap Test ◽  
Low Grade ◽  
Test Results ◽  
Pap Tests ◽  
Intraepithelial Lesion ◽  
Bethesda System

Abstract: Background: Cervical cancer is the fourth most common cancer in women with high mortality. Since it is a preventable cancer, screening for cervical cancer with Papanicolaou test (Pap Test) is considered as the stepping stone in its cure by detecting  at its premalignant state. The two methods of acquiring the sample for cytology are Conventional method and liquid based cytology. Methods:  The Pap test  results of the patients who visited the outpatient clinic of the Gynecologic Department of Gandaki Medical College and Teaching Hospital from January 2012 to December 2017 were reviewed and analyzed from the medical records. The findings of Pap test results were tabulated and categorized as per Bethesda system of classification (2001). Results:  A total of 2004 Pap tests were taken. All of the patients in the study were married with mean age of 39.7±10.3 years. A total of 1291(64.42%) Pap tests were normal or negative for intraepithelial lesion whereas 578(28.84%) were inflammatory smears while 37(1.85%) were inadequate for evaluation. There was a presence of low grade intraepithelial lesion in 4(0.2%)  and high grade intraepithelial lesion in 15(0.75%). Atypical squamous cell of undetermined significance (ASCUS) was noted in 11(0.55%) and frank malignancy was noted in 1(0.05%) of total Pap test samples. Conclusion: In a developing country like Nepal, Pap test is still the preferred cervical cancer screening tool. All women should undergo the screening test for cervical cancer with any feasible available test. Key words: Bethesda system; cervical cancer; HPV; Pap Test.

Pap Test Reporting Rates for Conventional Smear and Liquid-Based Cervical Cytology from the Largest Academic Women's Hospital in China: Analysis of 1,248,785 Pap Test Reports

2015 ◽  
Vol 59 (6) ◽  
pp. 445-451 ◽  
Author(s):  
Xiang Tao ◽  
R. Marshall Austin ◽  
Hao Zhang ◽  
Lihong Zhang ◽  
Jianan Xiao ◽  
...  
Keyword(s):  
Cervical Screening ◽  
Pap Test ◽  
Major Change ◽  
Cervical Cytology ◽  
Pap Smears ◽  
Pap Tests ◽  
Bethesda System ◽  
Liquid Based Cytology ◽  
The Bethesda System ◽  
Reporting Rates

Objective: The Obstetrics and Gynecology Hospital of Fudan University (OGHFU) in Shanghai is the largest academic women's hospital in China. Between 2009 and 2014, the use of liquid-based cytology (LBC) significantly increased while gradually adopting the Bethesda System (TBS), and in 2012 local regulations mandated that pathologists replace technicians to sign out Pap tests. Design: A retrospective OGHFU database search documented all Pap test reports between 2009 and 2014 by specimen type, either LBC or conventional Pap smears (CPS), and final reporting category. A total of 1,224,785 Pap reports were analyzed to document variations in Pap test reporting during a period of major change in cervical screening in China. Results: LBC gradually replaced CPS, which declined from over 65% of Pap tests in 2010 to 6.4% in 2014. Of 514,811 Pap reports using the traditional class system, class I (negative) reports accounted for 98.3% of results. With the introduction of TBS reporting, pathologist reviews and substantial replacement of CPS by LBC, the laboratory abnormal Pap test rate increased significantly to almost 5%. Conclusions: Changes in cervical cytology reporting between 2009 and 2014 in China's largest academic women's hospital reflected both increased use of LBC and the introduction of pathologist TBS reporting. Abnormality rates increased significantly and fell within CAP benchmark ranges.

scholarly journals Cervical cytochemistry: a potential adjunct to cytomorphology for detection of abnormal cells in cervical cancer screening

2020 ◽  
Vol 10 (1) ◽  
pp. 1639-1644
Author(s):  
Indrani Krishnappa ◽  
Kalyani R. ◽  
Raja Parthiban ◽  
Abhishek Agrawal
Keyword(s):  
Cervical Cancer ◽  
Acid Phosphatase ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cancer Detection ◽  
Pap Smear ◽  
Pap Test ◽  
Low Grade ◽  
Smear Examination ◽  
Intraepithelial Lesion

Background: Pap smear examination has been universally used as an effective screening tool for early detection of cervical carcinoma. The aim of this study was to assess the utility of Cervical Acid Phosphatase staining as an adjunct to routine Pap smear testing to improvethe sensitivity and specificity of routine Pap smear examination for cervical cancer detection. Materials and Methods: Cervical smears were taken from patients attending the gynecology department and a few cervical cancer screening programmes. One set of slides were alcohol fixed and stained with rapid pap stain and another set of slides were fixed in a special fixative and stained with Cervical Acid Phosphatase -Pap stain. The nuclear features of these Cervical Acid Phosphatase stained dysplastic cells was studied on Pap stain to diagnose cervical intraepithelial lesion/ malignancy. Results: Out of 489 cases included in the study 6 cases were diagnosed with intraepithelial lesion/ malignancy. On Cervical Acid Phosphatase -Pap stain 2 of the cases diagnosed as inflammatory smears on pap stain showed Cervical Acid Phosphatase positivity and thus were re evaluated. Mild nuclear atypia was observed in the Cervical Acid Phosphatase positive cells and these cases were diagnosed as Low grade squamous intraepithelial lesion and later biopsy proven to be Cervical intraepithelial Neoplasia I. Therefore Cervical Acid Phosphatase -Pap test was 100% sensitive and specific for cervical cancer detection. Conclusions: With 100% sensitivity Cervical Acid Phosphatase -Pap test satisfies the criteria of an efficient screening test.

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

2021 ◽  
Vol 5 (3) ◽  
Keyword(s):  
Vaginal Discharge ◽  
Pap Smear ◽  
Histopathological Examination ◽  
Pap Test ◽  
Pap Smears ◽  
Postmenopausal Bleeding ◽  
Parity Number ◽  
Medical City ◽  
Chief Complaints ◽  
Iraqi Women

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.

scholarly journals Family Planning Provider Referral, Facilitation Behavior, and Patient Follow-up for Abnormal Pap Smears

2009 ◽  
Vol 124 (5) ◽  
pp. 733-744 ◽  
Author(s):  
Holly C. Felix ◽  
Janet Bronstein ◽  
Zoran Bursac ◽  
M. Kathryn Stewart ◽  
H. Russell Foushee ◽  
...  
Keyword(s):  
Family Planning ◽  
Pap Smear ◽  
Health Department ◽  
Institutional Setting ◽  
Pap Smears ◽  
Title X ◽  
Rural Location ◽  
Factors Associated ◽  
Follow Up Care

Objectives. Family planning (FP) clinics are important access points for cervical cancer screening and referrals for follow-up care for abnormal Papanicolaou (Pap) smears for a substantial number of U.S. women. Because little is known about referral and facilitation practices in these clinics or client action based on referrals, we sought to determine FP provider referral and facilitation practices when seeing FP clients with abnormal Pap smear results, and FP client follow-up for abnormal Pap smears due to FP provider referrals. Methods. We conducted a mail survey of Medicaid-enrolled FP providers in Arkansas and Alabama, and conducted a telephone survey with a sample of FP clients of those providers responding to the provider survey. Results. Major provider factors associated with referral included rural location, health department and clinic institutional setting, large Title X practice/clinic size, and high FP clinic focus. Major factors associated with facilitation included rural location, non-physician specialty, health department and clinic institutional setting, and small Title X clinic size. Of women reporting abnormal results, 62.4% reported follow-up care. Of those who received follow-up care, 40.0% received some care and a referral from their FP provider. A major factor associated with clients seeking follow-up care was being told by their FP provider where to go for follow-up care. Age was a major factor associated with clients actually obtaining follow-up care. Conclusions. Where follow-up care is not available at the FP site, referrals are critical and are a major factor associated with whether women seek care for the condition. Interventions to increase follow-up rates should focus on provider and system features, rather than clients.

scholarly journals Spectrum of cytological patterns in cervical PAP smears in a tertiary care center of Western region of Nepal

2019 ◽  
Vol 4 (1) ◽  
pp. 2-8
Author(s):  
Pragya Gautam Ghimire ◽  
Durga BC Rawat ◽  
Kavita Sinha ◽  
Kamar Jahan ◽  
Richa Shrestha
Keyword(s):  
Cervical Cancer ◽  
Epithelial Cell ◽  
Pap Smear ◽  
Statistical Significance ◽  
Care Center ◽  
Tertiary Care ◽  
Pap Smears ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Intraepithelial Lesion

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.

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

2015 ◽  
Vol 1 (2) ◽  
pp. 50 ◽  
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

<p><strong>Background</strong>: 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.</p><p><strong>Objectives:</strong> 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.</p><p><strong>Methods</strong>: 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.</p><p><strong>Results</strong>: 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&lt;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&lt;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%.</p><p><strong>Conclusion</strong>: 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. </p>

Factors associated with regression of cervical dysplasia in adolescents: A retrospective study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5582-5582
Author(s):  
C. Chen ◽  
F. Campbell ◽  
J. Patruno ◽  
S. Kimmel ◽  
R. Boulay ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Pap Smear ◽  
Demographic Data ◽  
Cervical Dysplasia ◽  
Smoking History ◽  
Pap Smears ◽  
Factors Associated ◽  
Increased Risk ◽  
Chi Square Analysis

5582 Background: Sexually active adolescents have high rates of infection with human papilloma virus (HPV) and abnormal pap smears. They are considered a special population as they are likely to regress to normal cytology. The aim of our study was to identify factors associated with regression of cervical dysplasia in adolescents. Methods: We identified adolescent patients (aged 12–21 years) who had abnormal pap smears at the Center for Women's Medicine at Lehigh Valley Hospital in Allentown, PA, by CPT code from a database between Jan 2004 and Dec 2006. A chart review was performed to capture demographic data, cytology, smoking history, number of sexual partners, parity, race, contraceptive choice, use of barrier contraception. Chi-square analysis with logistic regression and multivariate analysis were used to identify factors associated with regression of cervical dysplasia. Results: Two-hundred two patients were identified. Mean age was 18.84 years (14–22 years). One hundred twenty-two (57.8%) were Hispanic, 71 (33.6%) Caucasian, and 16 (7.6%) Black. Fifty-two (24.6%) were pregnant at the time of diagnosis. Seventy-six (36%) were smokers. There were 125 (61.9%) cases of ASCUS, 33.7% (68 cases) LGSIL and 4.5% (9 cases) HGSIL on initial pap smear. One hundred eighteen (55.9%) patients had colposcopy, and of these, 32 (15.2%) had surgical intervention. Follow-up demonstrated that 72 (57.6%) patients had disease regression, 24 (19.2%) persistence and 29 (23.2%) progression. On multivariate analysis, patients who did not smoke were significantly more likely to show regression of cervical dysplasia on pap smear than women who smoked (OR 2.17, 95% CI 1.03–4.55, p = 0.039). Other factors were not statistically significant in predicting regression of cervical dysplasia. Conclusions: Adolescents who smoke were more likely to have persistent cervical dysplasia than non-smoking adolescents, putting smokers at an increased risk of advanced disease. We suggest that this subset have follow-up at shorter intervals and be enrolled in a smoking cessation program. No significant financial relationships to disclose.

Pap Hub: A system to improve compliance with pap smear screening guidelines in a large health care system.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 193-193
Author(s):  
Deanna Gek Koon Teoh ◽  
Lisa A. Fall ◽  
Erin A. Beitelspacher ◽  
Charles W. Lais
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Tracking System ◽  
Invasive Cervical Cancer ◽  
The United States ◽  
Pap Smears ◽  
Health Maintenance ◽  
Screening Guidelines ◽  
Pap Smear Screening

193 Background: Cervical cancer is the most prevalent gynecologic cancer worldwide, but is third in the U.S. due to pap smear screening. However, American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines are complex and frequently changed, resulting in guideline adherence as low as 33-44%. We describe a centralized pap smear tracking system (“pap hub”) and report preliminary results. Methods: On 1/1/13 we implemented the pap hub, routing all screening pap smear results to a dedicated OB/Gyn nursing staff with a new Epic workbench. Epic Health Maintenance Modifier updated to recommend pap smears for women age 21-65 years (not younger or older per guidelines). Screening Pap/HPV results auto routed to Pap Pool Epic inbasket (not to individual providers). Centralized nurse reviews results alongside past pap results on Pathology flowsheet in Epic If normal Normal history -> appropriate follow-up interval per screening guidelines If abnormal history -> repeat pap as determined by previous history and treatment If abnormal -> manage per ASCCP guidelines Document plan in Epic Result Note Update Epic problems list If Normal: document “Pap Hub Normal History” If Abnormal: document “Pap Hub Abnormal History” with specifics in Overview History Communicate results/plan to the patient. Update Health Maintenance Modifier with next step. Review abnormal results to ensure proper follow-up, with reminders as indicated. Results: Guideline recommendations against pap smears for patients <21 years and >65 years have not changed since 2009. Comparison of first-quarter data for 2010 (pre-Pap Hub) to 2013 (post-Pap Hub) have shown a 63.86% reduction in pap smears in women <21 years. Pap smears in women >65 years has always been low, but has decreased slightly from 2.4% of all pap smears in 2010 to 1.5% of all pap smears in 2013. The 2012 ASCCP guidelines have changed recommended pap smear frequency and abnormal pap smear follow-up, and compliance with these new recommendations is being collected. Conclusions: Pap smear screening has decreased the incidence of invasive cervical cancer in the United States. The Pap Hub, a centralized pap smear tracking system, improves compliance with pap smear screening guidelines.

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