Detection of abnormal cervical cytology in Papanicolaou smears

Background: Cervical cytology by Papanicolaou (Pap) smears is an effective means of screening for cervical premalignant and malignant conditions. Cervical intra-epithelial neoplasia (CIN) and cervical cancer remain important health problems for women worldwide. Aim: To study the role of Pap smear in detecting premalignant and malignant lesions of cervix; and to determine the prevalence of various lesions. Materials and Methods: This study is based on 300 patients who attended the out-patient Department of Obstetrics and Gynaecology. Pap smears were prepared from patients presenting with complaints like vaginal discharge, post-coital bleeding, inter-menstrual bleeding, dyspareunia, and pain lower abdomen. After fixation and staining, each smear was carefully examined. Results: Epithelial cell abnormalities were found in 5 smears, atypical squamous cells of undetermined significance (ASCUS) in 0.3, squamous intraepithelial lesion (SIL) in 3.4 which includes low grade squamous intraepithelial lesion (LSIL) (2.7) and high grade squamous intraepithelial lesion (HSIL) 0.7. Invasive carcinoma was seen in 1.3 cases. Mean age of the patients with diagnosis of LSIL was 32.3 years and for HSIL, it was 40.5 years. The mean age of the patients with invasive carcinoma was 57 years. Conclusion: Premalignant and malignant lesions of cervix are not uncommon in our set up and can be diagnosed early by Pap smears.