Study of cervical cytology in pap smears in a tertiary care hospital of North Maharashtra


  • Sakshi Agrawal Department of Pathology, JMF’s ACPM Medical College, Dhule, Maharashtra, India
  • Sumedh Agrawal Department of Medicine, Shri Bhausaheb Hire Government Medical College, Dhule, Maharashtra, India
  • Prashant Gupta Department of Pathology, JMC Jhalawar, Rajasthan, India



Cervical cancer, Pap smear, Screening


Background: Cervical cancer is the fourth leading cause of death in females worldwide. In India cervical cancer is the leading cause of morbidity and mortality. Cancer of cervix is preventable, and can be diagnosed at the pre-malignant stage with adequate and repetitive cytological screening by Papanicolaou (Pap) smears. Aim of this study was to study the role of Pap smear in detecting premalignant and malignant lesions as well as non-neoplastic lesions of cervix.

Methods: It is a retrospective study of 240 pap smears studied from January 2022 to June 2022 and received in pathology department of a tertiary care hospital of north Maharashtra. Samples are collected from women between 21 to 65 years presenting with some gynecological problems. Smears were reported as per the 2014 Bethesda system.

Results: Out of 240 women, 216 were having normal cytology and 146 cases with inflammatory changes. 10 cases were unsatisfactory. 5 cases of ASCUS, 1 case of SCC, 2 cases of HSIL and 6 cases of LSIL were observed.

Conclusions: Pap smear test is a simple, safe, noninvasive, economical OPD based procedure to detect pervasive cervical epithelial lesions. Every woman should undergo Pap test at least once in her life before the age of 45 years.


Rajaram S, Gupta B. Screening for cervical cancer: Choices & dilemmas. Ind J Med Res. 2021;154(2):210-20.

Bedell SL, Goldstein LS, Goldstein AR, Goldstein AT. Cervical cancer screening: past, present, and future. Sexual Med Revi. 2020;8(1):28-37.

Mehrotra R, Yadav K. Cervical Cancer: formulation and Implementation of Govt of India guidelines for screening and management. Indian J Gynecol Oncol. 2022;20:1-8.

Nilima N, Mani K, Kaushik S, Rai SN. Cervical Cancer Screening and Associated Barriers among Women in India: A Generalized Structural Equation Modeling Approach. Cancers. 2022;14(13):3076.

Verma A, Verma S, Vashist S, Attri S, Singhal A. A study on cervical cancer screening in symptomatic women using Pap smear in a tertiary care hospital in rural area of Himachal Pradesh, India. Middle East Fert Soci J. 2017;22(1):39-42.

Fontham ET, Wolf AM, Church TR, Etzioni R, Flowers CR, Herzig A, et al. Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society. CA: a Cancer J Clin. 2020;70(5):321-46.

Sarala K, Nalini Y, Prathyusha Y, Sandhya G. A retrospective study of thousand PAP smears at tertiary care center. Int J Contemp Med Res. 2017;4(12):7-10.

Srivastava AN, Misra JS, Srivastava S, Das BC, Gupta S. Cervical cancer screening in rural India: Status & current concepts. The Indian J Med Res. 2018;148(6):687.

Kiranmaie S. Cervical Cancer in India: An overview of preventive aspects. Int J Res Health Sci. 2013;1(3):226-9.

Maniyar.K, Wei.J, Pathology of cervical carcinoma. Glob Lib Women’s Med. 2017;1756-2228.

Volkova LV, Pashov AI, Omelchuk NN. Cervical carcinoma: oncobiology and biomarkers. Int. J Mol Sci. 2021;22:12571.

Sharma HB, Bansal M, Kumar N, Gupta M. Spectrum of pap smear cytology in women presenting in a tertiary care center in north India-a two year study. IP Arch Cytol Histopathology Res. 2021;6(1):7-11.

Raju K. Evolution of Pap Stain. Biomed Res Ther. 2016;3(2):490-500.

Nair GG, Shamsuddin F, Narayanan T, Balan P. Cytopathological pattern of cervical pap smears-a study among population of North Malabar in Kerala. Ind J of Pathol and Onco. 2016;3(4):552-7.

Tailor HJ, Patel RD, Patel PR, Bhagat VM. Study of cervical pap smears in a tertiary care hospital of South Gujarat, India. Int J Res Med Sci. 2016;4:286-8.

Singh AN, Sukhavasi C. Prevalence and analysis of abnormal Pap smear: Prospective study of 752 patients in a tertiary care hospital of South India. Obs Rev J obstet Gynecol. 2018;4(3):67-72.

Vedavathi V, Anusuya SK, Parimala BS. Analysis of cervical cytology using PAP smear in women residing in Bangalore Rural, India. J. Evid. Based Med. Healthc. 2019;6(51):3156-9.

Karra V, Ramulu PS, Rajanikar, Sudhakar B. Cervical pap smear study and its utility in cervical cancer detection and prevention. Indian J Obstet Gynecol Res. 2021;8(4):470-5.

Abraham A, Varghese S, Satheesh M, Vijayakumar K, Gopakumar S, Mendez AM. Pattern of gynecological morbidity, its factors and Health seeking behavior among reproductive age group women in a rural community of Thiruvananthapuram district, South Kerala. Ind J Comm Health. 2014:26(3):230-7.

Bal MS, Goyal R, Suri AK, Mohi MK. Detection of abnormal cervical cytology in Papanicolaou smears. J Cytol. 2012;29:45-7.

Sachan PL, Singh M, Patel ML, Sachan R. A study on cervical cancer screening using pap smear test and clinical correlation. Asia Pac J Oncol Nurs. 2018;5:337-41.

Umarani MK, Gayathri MN, Madhu Kumar. Study of cervical cytology in Papanicolaou (Pap) smears in a tertiary care hospital. Indi J Pathol Oncol. 2016;3(4):679-83.

Salodia L, Sharma M, Sharma R. Analysis of abnormal cervical cytology and its clinicopathological correlation in papanicolaou smears at tertiary care center - a prospective observational study. MedPulse Int J Gynaeco. 2020;13(2):69-74.

Ghosh S, Pattanshetty SM, Mallya SD, Pandey D, Guddattu V, Kamath VG, et al. Cervical cytology and associated factors among tribal women of Karnataka, India. PLoS ONE. 2021;16(3):e0248963.

Jadav MP, Patel FT, Shah BA, Parikh NR, Gonsai RN. A study of cervical pap smears in a tertiary care hospital of Ahmedabad, Gujarat, India. Inter J Clinical Diag Pathol. 2019;2(2):74-8.

Majumder N, Chakma S. A case study of 600 cervical pap smears in a tertiary hospital of northeast India in a Hilly State of Tripura. Ann Int Med Den Res. 2020;6(5):PT05-7.

Rose AAS. Pattern of Pap smear cytology: our experience. Int J Reprod Contracept Obstet Gynecol. 2016;5(10):3290-3.






Original Research Articles