Prospective observational study of cervical cancer screening by Pap smear in tertiary care hospital in hilly areas of Himachal Pradesh
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20243182Keywords:
Cervical cancer, HSIL, NILM, Pap smearAbstract
Background: Cervical cancer is major cause of morbidity and mortality in females. The majority of cervical cancer deaths are in developing, low- and middle-income countries. India is having highest age standardization incidence of cancer cervix at 22. Cancer cervix is major health problem and rank one malignancy in Himachal Pradesh. This study was an attempt to detect various lesions of cervix with the help of Pap smear as a screening tool and timely intervention of any abnormality.
Methods: Total 2139 women in age group of 21-65 years were screened by Pap smears who presented in OPD for various gynaecological complaints and as a routine beyond 45 years. The study was conducted at Kamla Nehru State Hospital Shimla Himachal Pradesh during period of 01.02. 2023 to 31.07. 2023. Pap smear testing was done by conventional method and reported according to Bethesda system.
Results: In the present study majority of women were in age group of 41-50 years (49.56%). On analysis of Pap smears 86.11% samples were reported as negative for intraepithelial lesion or malignancy (NILM). Atypical squamous cells of undetermined significance were found in 1.12%, low grade intraepithelial lesion 0.23%, high grade intraepithelial lesion 0.19%, adenocarcinoma and squamous cell carcinoma 0.05% each. On further sub categorization of NILM cytology reports inflammatory finding was commonest (52.06%).
Conclusions: Early and routine Pap smear screening is important for early diagnosis of premalignant cervical lesions and Cancer cervix as prevention is better than cure.
References
Joshi C, Kujur P, Thakur N. Correlation of Pap smear and colposcopy in relation to histopathological findings in detection of premalignant slesions of cervix in a tertiary care centre. Int J Sci Study. 2014;2(8):55-60.
WHO guidelines for screening and treatment of cervical precancer lesions for cervical cancer prevention. 2nd ed. Geneva: World Health Organization; 2021.
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 Fertil Soci J. 2017;22(1):39-42.
Thakur A, Gupta B, Gupta A, Chauhan R. Factors for cancer cervix among rural women of a hilly state: a case- control study. Ind J Public Hea. 2015;59(1):45-8.
Lakshmi PV, Gouri SR. Study and analysis of two hundred cervical Pap smears in our hospital. Int J Contemp Medi Res. 2016;3(9):2787-9.
Pap smear. By Healthline medical review team. Available at: www.healthline.com/health/pap-smear#Overview1/2015/11. Accessed 01 August 2024.
Nayir T, Okyay AR, Nizlican E, Yesilyurt H, Akbaba M, et al. Cervical cancer screening in an early diagnosis and screening centre in Mersin, Turkey. Asian Pac J Cancer Prev. 2015;16(16):6909-12.
Sreedevi A, Javed R, Dinesh A. Epidemiology of cervical cancer with special focus on India. Int J Women’s Health. 2015;7:405-14.
Bamanikar SA, Chandanwale SS, Baravkar DS, Dapkekar P. Study of cervical pap smears in a tertiary hospital. Ind Medi Gazette. 2014:250-254.
Patel MM, Pandya AN, Modi J. Cervical Pap smear study and its utility in cancer screening, to specify the strategy for cervical cancer control. Nat J Commu Medi. 2011;2(01):49-51.
Malpani G, Agrawal P, Verma AV, Khandelwal N, Tignath G. Cervical Pap smear study and detection of abnormal epithelial lesions and determination of its accuracy by cytohistological correlation in patients of tertiary care teaching hospital in central India. Int J Reprod Contracept Obstet Gynecol. 2016;5(7):2312-6.
Sengal D, Altinay S, Oksuz H, Demirturk H, Korkmazer E. Population based cervical screening outcomes in Turkey over a period of approximately nine and a half years with emphasis on results for women aged 30-34. Asian Pac J Cancer Prev. 2014;15(5):2069-74.
Ranabhat SK, Shrestha R, Tiwari M. Analysis of abnormal epithelial lesions in cervical Pap smears in Mid-Western Nepal. J Patho Nepal. 2011;1(1):30-3.
Mulay K, Swain M, Patra S, Gowrishankar S. A comparative study of cervical smears in an urban hospital in India and a population based screening programme in Mauritius. Indian J Pathol Microbiol. 2009;52(1):34-7.
Vaghela BK, Vaghela VK, Santwani PM. Analysis of abnormal cervical cytology in papanicolaou smears at tertiary care centre-A retrospective study. Int J Biomed Adv Res. 2014;5:47-9.
Padmini CP, Indira N, Chaitra R, Das P, Girish BC, Nanda KM, et al. Cytological and colposcopic evaluation of unhealthy cervix. J Evid Med Healthc. 2015;2:6920-7.
Nayani ZS, Hendre PC. Comparision and correlation of Pap smear with colposcopy and histopathology in evaluation of cervix. J Evol Med Dental Sci 2015;4(53):9236-47.
Karra V, Ramulu PS, Rajanikar SB. Cervical pap smear study and its utility in cervical cancer detection and prevention. Ind J Obstet Gynecol Res. 2021;8(4):470-5.
Satyanarayana L, Asthana S, Bhambani S, Sodhani P, Gupta S. A comparative study of cervical cancer screening methods in a rural community setting of North India. Ind J Cancer. 2014;51(2):124-8.
Arun R, Singh JP, Gupta SB. Cross-sectional study on visual inspection with acetic acid and pap smear positivity rates according to socio-demographic factors among rural married women of Bareilly (Uttar Pradesh). Indian J Community Med. 2018;43:86-9.
Basoya S, Anjankar A. Cervical cancer: early detection and prevention in reproductive age group. Cureus. 2022;14(11):1.