The incidence of cervical intraepithelial neoplasia in antenatal women by screening: a study in a semi urban area in Telangana, India

Beera Neelima, V. G. Vanamala


Background: Cervical intraepithelial neoplasia is a premalignant cervical disease which may lead to cervical cancer. The screening of the cervical cancer includes the screening of cervical cytology as well as testing for oncogenic human papilloma viruses (HPV) since most of the precursor lesions appear in the women of child bearing age. The purpose of the present study was to evaluate the incidence of cervical intraepithelial neoplasia in antenatal women by screening with papanicolaou smear.

Methods: Macroscopic abnormalities such as cervicitis, polyps, erosions, nabothian cysts, hypertrophied cervix, growths and ulcers were noted. A cervical smear using Ayre’s spatula was taken from the ecto cervix and spread on to a labeled slide and immediately fixed.

Results: Majority of the women were in the age group of 20-30 years in the study group. The overall mean age of the women in the study was around 25 years. The mean age at the time of menarche was around 14 years and at the time of marriage was approximately 22 years. On Pap smear, 55.2% of the 1000 cases were normal, with inflammation seen in 408 (40.8%) of the cases. 20 (2%) of the patients in our study had low grade squamous intra epithelial lesion, while 7 patients (0.2%) had high grade squamous intra epithelial lesion with two cases showing CIN II grading and 5 with CIN I.

Conclusions: An early detection of the same can lead to a proper and efficient treatment.


Antenatal women, Cervical intraepithelial neoplasia, Cervical cancer, Pregnant women

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Montz FJ. Management of high-grade cervical intraepithelial neoplasia and low-grade squamous intraepithelial lesion and potential complications. Clin Obstet Gynecol. 2000;43:394.

World Health Organization. Available at [Last Accessed on 2003 Aug 7].

IARC (International Agency for Research on Cancer) An Introduction to Cervical Intraepithelial Neoplasia (CIN). chapter 2. 2001.

Jemal A, Tiwari RC, Murray T. Cervical and vaginal cancer. Berek and Novac’s gynecology. 14. Philadelphia: Wolters Kluwer Publishers; 2009.

Frega A, Scirpa P, Corosu R, Verrico M, Scarciglia ML, Primieri MR et al. Clinical management and follow-up of squamous intraepithelial cervical lesions during pregnancy and postpartum. Anticancer Res. 2007;27:2743-6.

Bano F, Kolhe S, Zamblera D, Jolaoso A, Folayan O, Page L et al. Cervical screening in under 25s: a high-risk young population. Eur J Obstet Gynecol Reprod Biol. 2008;139:86-9.

Bosch FX, de Sanjosé S. The epidemiology of human papillomavirusinfection and cervical cancer. Dis Markers. 2007;23:213-27.

Lowy DR, Schiller JT. Prophylactic human papillomavirus vaccines. J Clin Invest. 2006;116:1167-73.

Snijders PJ, Steenbergen RD, Heideman DA, Meijer CJ. HPV-mediated cervical carcinogenesis: concepts and clinical implications. J Pathol. 2006;208:152-64.

Massad LS, Einstein MH, Huh WK, Katki HA, Kinney WK, Schiffman M et al. 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. J Low Genit Tract Dis. 2013;17:S1.

Ushijima KJ. Current status of gynecologic cancer in Japan. J Gynecologic Oncol. 2009;20:67-71.

Adisa JO, Sa'adatu BT, Bukar M, Egbujo EC. Prevalence of cervical intraepithelial neoplasia in relation to knowledge, attitudes/beliefs, and practices among university students in North-Eastern Nigeria. Annals Trop Med Public Health. 2013;6(4):418-21.

Bayo S, Bosch FX, de Sanjose S, Muñoz N, Combita AL, Coursaget P et al. Risk factors of invasive cervical cancer in Mali. Int J Epidemiol. 2000;31:202-9.

Schiff M, Becker TM, Masuk M, Asselt-King LV, Wheeler CM, Altobelli KK et al. Altobelli, Charles Q. North, and Andre J. Nahmias. Risk factors for cervical intraepithelial neoplasia in Southwestern American Indian women. Am J Epidemiol. 2000;152(8):716-26.

Al-Halal H, Kezouh A, Abenhaim H. Incidence and obstetrical outcomes of cervical intraepithelial neoplasia and cervical cancer in pregnancy. Archives Gynecol Obstet. 2012;287(2):245-50.

Ahdoot D, Van Nostrand KM, Nguyen NJ, Tewari DS, Kurasaki T, DiSaia PJ et al. The effect of route of delivery on regression of abnormal cervical cytologic findings in the postpartum period. Am J Obstet Gynecol. 1998;178(6):1116-20.

Obeidat RA, Saidi SA. Prevalence of high-grade cervical intraepithelial neoplasia (CIN) and cervical cancer in women with post-coital bleeding (PCB) and negative smear: a retrospective study. Gynecol Obstet. 2012;2:127.

d'Ottaviano-Morelli MG, Zeferino L, Cecatti JG, Terrabuio DR, Martinez EZ. Prevalence of cervical intraepithelial neoplasia and invasive carcinoma based on cytological screening in the region of Campinas, São Paulo, Brazil. Cadernos de Saúde Pública. 2012;20(1):153-9.

Rosenthal AN, Panoskaltsis T, Smith T, Soutter WP. The frequency of significant pathology in women attending a general gynaecological service for postcoital bleeding. BJOG. 2001;108(1):103-6.

Jain AG, Higgins RV, Boyle MJ. Management of low-grade squamous intraepithelial lesions during pregnancy. Am J Obstet Gynecol. 1997;177:298-302.

Holowaty P, Miller AB, Rohan T, To T. Natural history of dysplasia of the uterine cervix. J Natl Cancer Inst. 1999;91:252-8.

Paraskevaidis E, Koliopoulos G, Kalantaridou S, Pappa L, Navrozoglou I, Zikopoulos K et al. Management and evolution of cervical intraepithelial neoplasia during pregnancy and postpartum. Eur J Obstet Gynecol and Reprod Biol. 2002;104:67-9.

Fader AN, Alward EK, Niederhauser A, Chirico C, Lesnock JL, Zwiesler DJ et al. Cervical 7dysplasia in pregnancy: a multi-institutional evaluation. Am J Obstet Gynecol. 2010;203(2):113.e1-6.

Lurain JR, Gallup DG. Management of abnormal PAP smears in pregnancy. Obstet Gynecol. 1979;53:484-8.

Anorlu RI, Banjo AA, Odoemhum C. Cervical cancer screening: Level of awareness in women attending a primary health care facility in Lagos. Niger Postgrad Med J. 2000;70:25-8.