Screening for cervical abnormalities in antenatal patients with conventional pap smear

Krithika K.; Nandish S. Manoli; Preeti Gupta; Nishchal Anand P.

doi:10.18203/2320-1770.ijrcog20243173

Authors

Krithika K. Department of Obstetrics and Gynecology, The Oxford Medical College and Research Institute, Bengaluru, Karnataka, India
Nandish S. Manoli Department of Obstetrics and Gynecology, The Oxford Medical College and Research Institute, Bengaluru, Karnataka, India
Preeti Gupta Department of Obstetrics and Gynecology, The Oxford Medical College and Research Institute, Bengaluru, Karnataka, India
Nishchal Anand P. Department of Obstetrics and Gynecology, The Oxford Medical College and Research Institute, Bengaluru, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20243173

Keywords:

Psychological impact, Pap smear, HPV, Educational interventions, Cervical cancer screening, Antenatal women, Cervical abnormalities

Abstract

Background: Cervical cancer screening is crucial for early detection and management of cervical abnormalities, especially in antenatal women who may not regularly undergo such screening. This study assessed the incidence of Pap smear abnormalities among antenatal women at The Oxford Medical College & Hospital.

Methods: A descriptive cross-sectional study was conducted over 12 months, involving 114 antenatal women. Pap smear tests were analysed using the Bethesda System 2001 criteria. Data on demographic characteristics, knowledge of cervical cancer, and reasons for not undergoing Pap smear were also collected.

Results: The majority of the smears were inflammatory (35.1%), followed by bacterial vaginosis (24.6%) and vaginal candidiasis (14.9%). No high-grade lesions were detected. The mean age of participants was 26.11 years, with a significant portion (39.5%) aged between 21-25 years. Educational status varied, with 29.8% having attained higher education. Knowledge about cervical cancer and Pap smears was low (12.3% and 22.8%, respectively). Socioeconomic factors played a role in screening uptake, with 48.2% belonging to the middle socioeconomic class.

Conclusions: The study highlights the absence of high-grade cervical abnormalities among antenatal women in our cohort and underscores the need for integrating cervical cancer screening into routine antenatal care. Addressing educational and psychological barriers could enhance screening uptake.

Metrics

Metrics Loading ...

References

Arbyn M, Weiderpass E, Bruni L, de Sanjosé S, Saraiya M, Ferlay J, et al. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Health. 2020;8(2):e191-e203.

Sasieni P, Castanon A, Cuzick J. Effectiveness of cervical screening with age: population based case-control study of prospectively recorded data. BMJ. 2009;339:b2968.

Gakidou E, Nordhagen S, Obermeyer Z. Coverage of cervical cancer screening in 57 countries: low average levels and large inequalities. PLoS Med. 2008;5(6):e132.

Kyrgiou M, Koliopoulos G, Martin-Hirsch P, Arbyn M, Prendiville W, Paraskevaidis E. Obstetric outcomes after conservative treatment for intraepithelial or early invasive cervical lesions: systematic review and meta-analysis. Lancet. 2006;367(9509):489-98.

Nanda K, McCrory DC, Myers ER, Bastian LA, Hasselblad V, Hickey JD, et al. Accuracy of the Papanicolaou test in screening for and follow-up of cervical cytologic abnormalities: a systematic review. Ann Intern Med. 2000;132(10):810-9.

Lees BF, Erickson BK, Huh WK. Cervical cancer screening: evidence behind the guidelines. Am J Obstet Gynecol. 2016;214(4):438-43.

American College of Obstetricians and Gynecologists. Practice Bulletin No. 168: Cervical Cancer Screening and Prevention. Obstet Gynecol. 2016;128(4):e111-30.

Canfell K, Sitas F, Beral V. Cervical cancer in Australia and the United Kingdom: comparison of screening policy and uptake, and cancer incidence and mortality. Med J Aust. 2006;185(9):482-6.

Akers A, Newmann SJ, Smith JS. Factors underlying disparities in cervical cancer incidence, screening, and treatment in the United States. Curr Probl Cancer. 2007;31(3):157-81.

Wiesenfeld HC, Hillier SL, Krohn MA, Landers DV, Sweet RL. Bacterial vaginosis is a strong predictor of Neisseria gonorrhoeae and Chlamydia trachomatis infection. Clin Infect Dis. 2003;36(5):663-8.

Prabhu RB, Velayudham D, Nethaji S, Singhal H, Venkatachalam R. Opportunistic cervical cancer screening in pregnancy. Int J Medi Res Heal Sci. 2016;5(1):278-81.

Thangarajah F, Einzmann T, Bergauer F, Patzke J, Schmidt-Petruschkat S, Theune M, et al. Cervical screening program and the psychological impact of an abnormal Pap smear: a self-assessment questionnaire study of 590 patients. Arch Gynecol Obstetr. 2016;293:391-8.

Khaengkhor P, Mairaing K, Suwannarurk K, Thaweekul Y, Poomtavorn Y, Pattaraarchachai J, Bhamarapravatana K. Prevalence of abnormal cervical cytology by liquid based cytology in the antenatal care clinic, Thammasat University Hospital. J Medi Associ Thail. 2011;94(2):152.