Rajavarapu Rajeswari1, Kancharla Sushma Chandulee2, Kona Suneetha3, Boddu Penchala Prasanna4
BACKGROUND
Cervical cancer is one of the most common forms of cancer. In India it is the
second most common cancer after breast carcinoma. PAP smear is the best
screening method to reveal spectrum of lesions in cervix ranging from
inflammatory to the neoplastic process. Because of easy accessibility of cervix,
cervical screening is helpful for ready diagnosis of 90 % to 96 % cytological
abnormalities even in the pre-invasive stage. We wanted to evaluate the
importance of PAP smear examination as a preliminary method accommodating
histopathology and assess the spectrum of lesions.
METHODS
The study was done to identify the target age groups for the early detection of
cancerous cervix by PAP smear examination. The study was done on patients who
attended government general hospital (GGH), Ongole, from January 2018 to
December 2019. Lesions were categorized based on 2014 Bethesda system as
negative intraepithelial lesion for malignancy (NILM) / Inflammatory, benign,
premalignant, and malignant. The clinicocytological and histopathological
examination (HPE) of cervical biopsy of corresponding smears were compared and
analysed in the present study.
RESULTS
Of the 584 cases studied by PAP smear examination, maximum number of patients
were between 21 and 60 years of age. Maximum number of patients came with
the complaint of white discharge. Highest number of cases reported were NILM /
inflammatory (54.18 %), followed by atypical squamous cells of undetermined
significance (ASCUS) (20.68 %), high-grade squamous intraepithelial lesion (HSIL)
(13.84 %), squamous cell carcinoma (SCC) (6.84 %), low-grade squamous
intraepithelial lesion (LSIL) (1.65 %), metaplasia (1.19 %), atypical glandular cells
of undetermined significance (AGUS) (0.51 %), adenocarcinoma (0.17 %).
CONCLUSIONS
Cervical PAP smear screening is simple, cost effective and reliable method for early
detection of cervical cancers. Classification of lesions based on Bethesda
terminology is most informative and useful. Correlation of PAP smear cervical
cytology with gold standard HPE provides greater efficacy in diagnosis.
