Cervical Pap Smear Study for Screening of Pre-Cancerous Conditions of Cervix

Background: Carcinoma of the cervix is 3rd most common carcinoma of women. It is a leading cause of morbidity and mortality in India. About 86% of cases occur in developing countries and 88% deaths occur due to cervical carcinoma in developing countries. Pap smear is a simple, non-invasive, cost-effective tool in every Gynaecological OPD which can detect abnormal cytological findings of cervix. It can detect pre-cancerous lesions of the cervix at the earliest and effective early treatment can save women from morbidity and mortality. Aims and objectives: To determine the prevalence of pre-cancerous conditions of the cervix in hospital to study demographic & other associated risk factors. Materials and methods: A Hospital based cross -sectional study was conducted. This was questionnaire based study. Questionnaire was administered to 500 women attending Gynaecological OPD. The questionnaire consisted of the questions regarding the knowledge and awareness about different aspects of cervical cancer. All relevant socio-demographic parameters, detailed history, clinical examination, per speculum examination, Pap smear cytological study was done. This study was approved by Institutional ethical committee. 500 women coming to Gynec OPD with chronic discharge P/V, post-coital bleeding, Post-menopausal bleeding P/V, other menstrual abnormalities, lower abdominal pain and routine Pap smear screening between age group 18 (0r age of 1st coitus-whichever was low) till 65 years of age were included in the study. The data collected during the survey was entered in micro -soft excel and analyzed via SPSS (Statistical Package for the Social Sciences) SPSS VERSION 20. Results: Out of 500 cases studied, 458 cases (91.6%) were satisfactory according to Bethesda System. The epithelial cell abnormalities constituted 42 (8.4%). Maximum no. of cases 210(42%) were in age group > 40 years. Co-relation of early marriage/1st coitus and increasing age with abnormal cytological findings was statistically significant (p value 0.001) along with cervical morbidity on per speculum findings. The statistically significant co-relation was found (p value 0.001) between multi -parity (40.7%) and abnormal cervical smear findings. ASCUS was (5.4%) followed by LSIL (1.4%), HSI L (0.8%) and SCC (0.8%). Conclusion: The study clearly shows relatively high prevalence of epithelial abnormalities in cervical Pap smear with increasing age, parity and early age at first coitus in symptomatic women with clinical lesions on per speculum findings. Effective screening with Pap smear definitely helps in early detection of Precancerous lesions of cervix Effective, frequent Pap smear screening programmes should be organised in India, even in the remotest rural areas to prevent the incidence of invasive cervical carcinoma.