Spectrum of Cytological Patterns in Cervical Pap Smears of Symptomatic Women in a Tertiary Care Hospital of Rajasthan.

Background: Cervical cancer is the third most common cause of death among women in developing countries including India. To decrease morbidity and mortality associated with cervical cancer, a pap smear screening test is advised before the age of 45 with or without symptom. The aim of the study is to evaluate Pap smear screening method for detection of precancerous lesions of cervix in symptomatic women. Material and methods:The study was conducted over one year period with effect from Jan 2018 to Dec 2018. A total of 1680 cases were received. Out of 1680 cases only 466 cases were included for this study on the basis of inclusion and exclusion criteria. A detailed history was taken in all the women and that included personal information, history, and clinical examination. Smears were made with the conventional method according to standard medical literature and stained with Ultra-Fast Papanicolaou Staining kit. The stained slides were reported according to the Bethesda Classification system (2014). Results:None of the women who participated in the study had pap smear testing earlier in life. Majority of women included in the study were in the age group of 41-65 years with a mean age of 38.93 years ±12.66. Seventy-seven women among the 466 cases had achieved their menopause. Out of the 466 cases, 448 (96.1%) were parous and 18 women(3.9%) were nulliparous. The commonest presenting complaints in our study was white vaginal discharge which was in 182 (39.1%) cases followed by abnormal bleeding per vagina in 60 (12.9%) cases and pain abdomen in 46(9.9%). On microscopy 320 (68.7%) cases were reported as negative for intraepithelial lesion or malignancy(NILM), 9(1.9%) as high grade squamous intraepithelial lesion(HSIL), 5(1.1%) as low grade squamous intraepithelial lesion(LSIL), 6(1.3%) as Atypical squamous cells of undetermined significance(ASCUS), 6 (1.3%) as squamous cell carcinoma(SCC), 3 (0.6%) as Atypical squamous cells-cannot exclude HSIL(ASC-H) and 1 (0.2%) as atypical glandular cellsnot otherwise specified(AGC-NOS) respectively. Conclusions: With increasing awareness of pap test among the women by education can significantly reduce treatment burden, morbidity and mortality. [ABSTRACT FROM AUTHOR]