Published: 2020-01-28

Analytical study of Pap smear reports over a period of 1 year in a tertiary care centre

Mehak Reyaz, Nupur Nandi, Ritika Aggarwal


Background: Cervical cancer is the fourth most common cancer in women. In India and other developing countries cervical cancer is the leading cause of morbidity and mortality. Cancer cervix continues to be most common genital carcinoma in India accounting for 80% of all female genital malignancies. Pre-invase lesions can spontaneously regress to normal or remain stable for long period or progress to a higher degree of dysplasia. Cancer of cervix is preventable if diagnosed at the pre-invasive stage with regular intervals of cytological screening by Papanicolaou (Pap) smears. The aim of the study is to analyse the pap reports in terms of normal findings, infections, premalignant lesions and invasive cancers.

Methods: All women attending the outpatient department gynaecology at TMMC and RC Moradabad, Uttar Pradesh over a period of 1 year from august 2017-18 presented of obstetrics and with white discharge per vagina were screened for cervical cancer using pap smear. All the smears were reported as per the 2014 Bethesda system.

Results: Out of 1392 Pap smear reports ASCUS was reported in 27 cases (2%), LSIL in 27 cases (2%), HSIL in 15 cases (1%), malignant cells in 15 cases (1%) and normal including the infection is reported in 1308 cases (94%).

Conclusions: Early cervical epithelial changes can be identified by a Pap smear test, which is the primary screening test for detection of precancerous cervical intraepithelial neoplasia and the early stage of invasive cervical cancer.


Atypical typical squamous cell of undetermined significance, Cervical cancer, Cytology, High grade squamous intraepithelial lesion, Low grade squamous intraepithelial lesion, Pap smear

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Cecilia NC, Rosliza AM, Suriani I. Global burden of cervical cancer; a literature review. Int J Public Health Clin Sci. 2017;4(2):10-8.

WHO Cervical Cancer statistics worldwide. 2018. CA. A Cancer J Clin. 2018;1-31.

Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359-86.

Parkin FJ, Pisani P. Cancer Incidence, mortality and prevalence worldwide: Sources, methods and major patterns in GLOBOLAN 2002. IARC. 2005;55(2):74-108.

Duraisamy K, Jaganathan KS, Bose JC. Methods of detecting cervical cancer. Adv Biol Res. 2011;5(4):226-32.

Jones SC, Johnson K. Women's awareness of cancer symptoms: a review of the literature. Woman’s Health (Lond). 2012;8:579-91.

Franco EL, Duarte Franco E, Ferenczy A. Cervical cancer: epidemiology, prevention and role of human papillomavirus infection. CMAJ. 2001;164(7):1017-25.

Patel MM, Pandya AN, Modi J. Cervical Pap smear study and its utility in cancer screening, to specify the strategy for cervical cancer control. National J Comm Med. 2011;2:49-51.

Behtash N, Mehrdad N. Cervical Cancer: Screening and Prevention. Asian Pac J Cancer Prev. 2006;7(4):683-6.

Fahey MT, Irwig L, Macaskill P. Meta-analysis of Pap test accuracy. Am J Epidemiol. 1995;141(7):680-9.

Mitchell MF, Schottenfeld D, Tortolero-Luna G, Cantor SB, Richards-Kortum R. Colposcopy for the diagnosis of Squamous intraepithelial lesion: A Meta-analysis. Obstet Gynecol. 1998;91(4):626-31.

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

American College of Gynecologists. ACOG Practice Bulletin No. 99: management of abnormal cervical cytology and histology. Obstet Gynecol. 2008;112(6):1419-44.

Bamanikar SA, Baravkar DS, Chandanwale SS, Dapkekar P. Study of cervical Pap smears in a Tertiary Hospital. Indian Med Gazette. 2014:250-4.

Patel CB, Shah PC, Bhagat VM. A role of cervical Pap smear as a screening tool in diagnosis of lesions of cervix-a one-year study. Int J Med Sci Public Health. 2016;5(9):1841-6.

Chaudhary RD, Inamdar SA, Hari Haran C. Correlation of diagnostic efficacy of unhealthy cervix by cytology, colposcopy and histopathology in women of rural areas. Int Reprod Contracept Obstet Gynecol. 2014;3(1):213-8.

Gupta R, Gupta SG, Mishra KB. Pattern of Pap smear cytology and its histopathological correlation at a tertiary care center. Rec Adv Path Lab Med. 2016;2(2):13-9.

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

Lakshmi PV, Sree Gouri SR. Study and analysis of two hundred cervical PAP smears. Int J Contem Med Res. 2016;3(9):2787-9.

Mandakni MP, Amrish NP, Jigna M. Cervical pap smear study and its utility in cancer screening, to specify the strategy for cervical cancer control. National J Comm Med. 2011;2(1):50.

ACOG Practice Bulletin. Clinical management guidelines for obstetrician-gynaecologists; 2009.

Cheryl LR, Clair WM, Kevin R. Prevention of cervical cancer. Crit Rev Oncol/Haematol. 2000;33:169-85.

Tejeswini V, Premalath P. Pap smear examination- its utility in various cervical lesions. Indian J Pathol Oncol. 2016;3(2):242-6.