SPECTRUM OF PAP SMEAR CYTOLOGY IN WOMEN PRESENTING IN A TERTIARY CARE CENTER
DOI:
https://doi.org/10.7492/genbm575Keywords:
Cervical cancer, Pap smear, Cervical cytology, Bethesda system, Epithelial cell abnormality, Tertiary care hospitalAbstract
Background: ervical cancer remains a significant public health problem, particularly in low- and middle-income countries where organized
screening programs are limited. The Papanicolaou (Pap) smear is a simple, cost-effective screening tool for early detection of cervical epithelial
abnormalities. Evaluating the spectrum of Pap smear cytology in tertiary care settings helps understand disease patterns and optimize
opportunistic screening strategies.
Objectives:To assess the spectrum of cervical cytological findings on Pap smear examination among women attending a tertiary care center and
to analyze the association of epithelial cell abnormalities with demographic, clinical, and cytological factors.
Methods:A retrospective, descriptive, cross-sectional study was conducted over six months in a tertiary care teaching hospital. Records of 1490
women who underwent Pap smear examination were reviewed. Smears were collected using Ayre’s spatula, stained by the conventional
Papanicolaou method, and reported according to The Bethesda System 2014. Data on age, clinical indications, smear adequacy, transformation
zone representation, cytological diagnosis, and infective findings were analyzed using descriptive statistics and appropriate inferential tests.
Results:Most women were aged 21–50 years (70.7%). Pap smears were predominantly performed for symptom-based indications, while routine
screening accounted for 19.9% of cases. Satisfactory smears constituted 95.0%, and the transformation zone was represented in 73.0%. The
majority of smears were reported as negative for intraepithelial lesion or malignancy (98.7%). Epithelial cell abnormalities were detected in
12.3%, mainly ASC-US (0.3%) and ASC-H (0.6%). Adenocarcinoma was identified in 0.1% of cases. Significant associations were observed
between epithelial cell abnormalities and postmenopausal bleeding, inflammatory smears, and adequate transformation zone representation.
Conclusion:Pap smear cytology remains an effective screening tool for detecting cervical epithelial abnormalities in tertiary care settings.
Strengthening opportunistic screening and ensuring optimal sampling of the transformation zone may enhance early detection and contribute to
cervical cancer prevention.
