Detection of Abnormal Cervical Cytology in Papanicolaou Smears in a Tertiary Care Center

Abstract

Introduction: Cancer of uterine cervix is a leading cause of mortality and morbidity among women
worldwide. In developing countries it is the most common gynaecological cancer and one of the
leading causes of cancer death among women. Pap smears are commonly used as cytological
screening test for successful eradication of precancerous lesions, which has made it a routine
procedure worldwide.

Methods: This descriptive study was conducted at Kathmandu Medical College Teaching Hospital,
Kathmandu within a period of two years from January 2011 to December 2012. A total of 1369 cases
were screened.

Results: In this study, cytological examination of the smears showed 944 (68.95%) inflammatory
smears, 301(21.99%) normal smears, 101(7.38%) atrophic smears, seven (0.51%) ASCUS, two (0.15%)
LSIL, four (0.29%) HSIL and two (0.15%) squamous cell carcinoma. Radiation changes were seen in
three (0.22%) cases. Of all the smears studied five (0.36%) cases were inadequate. Regarding ethnicity,
incidence of epithelial cell abnormalities was high in Tamang (5 cases). Eleven cases (73.33%) of
epithelial cell abnormalities were seen in patients from urban areas.

Conclusions: In country like Nepal with predominant rural population, screening and awareness
programs with co-operation of media, non-government organizations and government should be
formulated for early detection of cervical cancer.
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Keywords: Bethesda system; cervical intraepithelial lesions; pap smear
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