Volume 7, Issue 2 (Journal of Clinical and Basic Research (JCBR) 2023)                   jcbr 2023, 7(2): 26-29 | Back to browse issues page


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1- Department, GMERS Medical College, Panchmahal, Gujarat, India , devdev966@gmail.com
2- Department, VIMS, Palghar, Maharastra, India
3- Navsari, Gujarat, India
Abstract:   (897 Views)
Background: Cervical cancer is the most frequent cause of death for women in developing countries. India, the second-most populous nation in the world, accounts for about 25% of cervical cancer deaths. Even in its premalignant stage, cervical cancer can be detected using a Papanicolaou (Pap) smear test.
The goal was to study the role of Pap smear in detecting premalignant, malignant, and non-neoplastic lesions of the cervix and to ascertain the frequency of different lesions.
Methods: All women who visited the obstetrics and gynecology outpatient department (OPD) at GMERS Medical College and Hospital, Navsari, India, in 1 year for different clinical problems were recruited. A total of 322 women who were sexually active and over 21 years of age were enrolled in the study. A Pap smear was used for all the women to screen for cervical cancer. The smear was obtained using an Ayre spatula and spread over a marked glass slide, which was placed in 95% ethyl alcohol and sent to the Department of Pathology for cytopathological examination. Women who had visible malignant cervical lesions were excluded. All the data were recorded in a predetermined form.
Results: A total of 322 patients were screened. Out of 322, 261 smears were NILM (negative for intraepithelial lesion or malignancy) and 126 (39.1 %) smears had inflammatory changes; 2.2 % and 1.2% smears showed changes as ASCUS (atypical squamous cells of undetermined significance) and ASC-H (atypical squamous cells cannot exclude high-grade squamous intraepithelial lesions), respectively; 4.7 % and 5.3% smears showed LSIL (low-grade squamous intraepithelial lesion) and HSIL (high-grade squamous intraepithelial lesion). Squamous cell carcinoma was observed in only 2 (0.6%) of the smears. A total of 16 (4.9%) smears were unsatisfactory for evaluation because they lacked sufficient squamous components or were obscured by inflammation.
Conclusion: The Pap smear test is a very easy, non-invasive, useful, simple, safe, and economical tool to detect preinvasive cervical epithelial lesions. It is evident and proven that every woman above the age of 30–35 years must be subjected to cervical screening, and this must be continued even in the postmenopausal period.
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Article Type: Research | Subject: Obstetrics and Gynecology

References
1. Ali F, Kuelker R, Wassie B. Understanding cervical cancer in the context of developing countries. Ann Trop Med Public Health. 2012;5(1):3-15. [View at Publisher] [DOI] [Google Scholar]
2. 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(5):E359-86. [View at Publisher] [DOI] [PMID] [Google Scholar]
3. 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(5): E359 86. [View at Publisher] [DOI] [PMID] [Google Scholar]
4. World Health Organization: International Agency for Research on Cancer. Estimated cancer Incidence, mortality, and prevalence worldwide in 2012. GLOBOCAN. 2012. [View at Publisher] [Google Scholar]
5. Bal MS, Goyal R, Suri AK, Mohi MK. Detection of abnormal cervical cytology in Papanicolaou smears. J Cytol. 2012;29(1):45-7. [View at Publisher] [DOI] [PMID] [Google Scholar]
6. Carmichael JA, Clarke DH, Moher D, Ohlke ID, Karchmar EJ. Cervical carcinoma in women aged 34 and younger. Am J Obstet Gynecol. 1986;154(2):264-9. [View at Publisher] [DOI] [PMID] [Google Scholar]
7. Task force convened by the Department of National Health and Welfare. Cervical cancer screening programs: summary of the 1982 Canadian task force report. Can Med Assoc J. 1982;127(7):581-9. [View at Publisher] [PMID] [Google Scholar]
8. Kulkarni PR, Rani H, Vimalambike MG, Ravishankar S. Opportunistic screening for cervical cancer in a tertiary hospital in Karnataka, India. Asian Pac J Cancer Prev. 2013;14(9):5101-5. [View at Publisher] [DOI] [PMID] [Google Scholar]
9. Satija A. Cervical Cancer in India. South Asia Centre for Chronic Disease. 2014. [View at Publisher] [Google Scholar]
10. Arbyn M, Castellsagué X, de Sanjosé S, Bruni L, Saraiya M, Bray F, et al. Worldwide burden of cervical cancer in 2008. Ann Oncol. 2011;22(12):2675-86. [View at Publisher] [DOI] [PMID] [Google Scholar]
11. Aswathy S, Quereshi MA, Kurian B, Leelamoni K. Cervical cancer screening: Current knowledge and practice among women in a rural population of Kerala, India. Indian J Med Res. 2012;136(2):205-10. [View at Publisher] [PMID] [Google Scholar]
12. Nayar R, Wilbur DC. The Pap test and Bethesda 2014: "The reports of my demise have been greatly exaggerated". (after a quotation from Mark Twain). J Am Soc Cytopathol. 2015;4(3):170-80. [View at Publisher] [DOI] [PMID] [Google Scholar]
13. 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 Commun Med. 2011;2(01):49-51. [View at Publisher] [Google Scholar]
14. Hakma M, Miller AB, Day NE, editors. Screening for cancer of the uterine cervix : from the IARC Working Group on Cervical Cancer Screening and the UICC Project Group in the Evaluation of Screening Programmes for Cancer. Lyon: International Agency for Research on Cancer;1986. [View at Publisher] [Google Scholar]
15. Okonda S, Wright C, Michelow P. The status of cervical cytology in Swaziland, Southern Africa: A descriptive study. Cytojournal. 2009;6:14. [View at Publisher] [DOI] [PMID] [Google Scholar]
16. Ajah LO, Ezeonu PO, Ozonu NC, Iyoke CA, Nkwo PO, Ajah MI. A five-year review of cervical cytology in Abakaliki, Nigeria. Am J Cancer prev. 2015;3(2):23-6. [View at Publisher] [DOI] [Google Scholar]
17. Department of National Health and Welfare. Cervical cancer screening programs: Summary of the 1982 Canadian task force report. Can Med Assoc J. 1982;127(7):581 9. [View at Publisher] [Google Scholar]
18. Jadav MP, Patel FT, Shah BA, Parikh NR, Gonsai RN. A study of cervical pap smear in tertiary care hospital of Ahmedabad, Gujarat, India. Int J Clin Diagn Pathol. 2019;2(2);74-8. [View at Publisher] [DOI] [Google Scholar]
19. Vaghela B, Vaghela VK, Santwani PM. Analysis of abnormal cervical cytology in Papanicolau smears at tertiary care center A retrospective study: Int J Biomed Adv Res. 2014;5(1):47-9. [View at Publisher] [DOI] [Google Scholar]
20. Tailor HJ, Patel RD, Patel PR, Bhagat VM. Study of cervical pap smears in a tertiary care hospital of south Gujarat, India. Int J Res Med Sci. 2016;4(1):286-8. [View at Publisher] [DOI] [Google Scholar]
21. Shashidhar MR, Shikha J. Prevalence of cervical cancer and role of screening programs by PAP smears. Medpulse Int J Pathol. 2017;1(2):32-6. [View at Publisher] [DOI] [Google Scholar]
22. Thomas A, Corrara Majoria MA, Kumar KR. The Bethesda System recommendation in reporting benign endometrial cells in cervical smears. From postmenopausal women published by Americal cancer Society. Indian J Pathol Microbiol. 2002;45(1):134-8. [View at Publisher] [Google Scholar]
23. Chauhan SH, Tayal OK, Kalia IJ. Detection of uterine cervical dysplasia and carcinoma cervix. Indian J Obst and Gynecol. 1990;17:419-21. [View at Publisher] [Google Scholar]
24. Kalpna Mital, Usha Agarwal VK, Sharma jaiswal TBL. Evaluation of cytological and histological examination in precancerous and cancerous lesions among gynecological diseases. Indian J Obst Gynecol. 1989;42(8):713-5. [View at Publisher] [Google Scholar]
25. Nayir T, Okyay RA, Nazlican E, Yesilyurt H, Akbaba M, Ilhan B, et al. Cervical cancer screening in an early diagnosis and screening center in Mersin, Turkey. Asian Pac J Cancer Prev. 2015;16(16):6909-12. [View at Publisher] [DOI] [PMID] [Google Scholar]
26. Bal MS, Goyal R, Suri AK, Mohi MK. Detection of abnormal cervical cytology in Papanicolaou smears. J Cytol. 2012;29(1):45-7. [View at Publisher] [DOI] [PMID] [Google Scholar]
27. Kothari S, Gohel A, Dayal A, Shah R, Patel S. Pap smear - A tool for detection of cervical intraepithelial lesions in health check-up schemes: A study of 36, 740 cases. Int J Res Med. 2014;3:12-5. [View at Publisher] [Google Scholar]
28. Nair GG, Shamsuddin F, Narayanan T, Balan P. Cytological pattern of cervical pap smears - a study among the population of North Malabar in Kerala. Ind J Pathol Oncol. 2016;3(4):552-7. [View at Publisher] [DOI] [Google Scholar]
29. Gupta K, Malik NP, Sharma VK, Verma N, Gupta A. Prevalence of cervical dysplasia in western Uttar Pradesh. J Cytol. 2013;30(4):257-62. [View at Publisher] [DOI] [PMID] [Google Scholar]
30. George P, Rao S. Cytology of uterine cervix by Pap smear: a study from South India. J of Evolution of Med and Dent Sci. 2014;3(63):13796-803. [View at Publisher] [DOI] [Google Scholar]
31. Misra JS, Srivastava S, Singh U, Srivastava AN. Risk factors and strategies for control of carcinoma cervix in India: hospital-based cytological screening experience of 35 years. Indian J Cancer. 2009; 46(2):155-9. [View at Publisher] [DOI] [PMID] [Google Scholar]
32. Sarma U, Mahanta J, Talukdar K. Pattern of Abnormal Cervical Cytology in women attending a Tertiary Hospital. IJSRP. 2012;2(12):1-4. [View at Publisher] [Google Scholar]
33. Padmini CP, Indira N, Chaitra R, Das P, Girish B, Gopal N, et al. Cytological and colposcopic examination of the unhealthy cervix. J Evid Med Healthc. 2015;2(40):6783-90. [View at Publisher] [DOI] [PMID] [Google Scholar]
34. Shaki O, Chakrabarty BK, Nagaraja N. A study on cervical cancer screening in asymptomatic women using pap smear in tertiary care hospital in an urban area of Mumbai, India. J Family Med Prim Care. 2018;7(4):652-7. [View at Publisher] [DOI] [PMID] [Google Scholar]
35. Varghese C, Amma NS, Chitrathara K, Dhakad N, Rani P, Malathy L, et al. Risk factors for cervical dysplasia in Kerala, India. Bull World Health Organ. 1999;77(3):281-3. [View at Publisher] [PMID] [Google Scholar]
36. Suma RK, Yalaburgi KS. Screening of pre-cancer and cancer cervix by Pap smear among women in reproductive age group: a community-based study. Int J Commun Med Public Health. 2019;6(1):129-34. [View at Publisher] [DOI] [Google Scholar]
37. Nikumbh DB, Nikumbh RD, Dombale VD, Jagtap SV, Desai SR. Cervicovaginal cytology: Clinicopathological and social aspect of cervical cancer screening in rural (Maharashtra) India. Int. J. Health Sci Res. 2012;1(2):125-32. [View at Publisher] [Google Scholar]

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