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Research Article

Volume 1 Issue 3 - 2015

Frequency of Cervical Intraepithelial Neoplasia in the Patients Screened By Pap Smear at a Tertiary Care Setup

Shahida Akhtar¹, Mehwish Malik² and Waqar Ahmed³

¹Professor and Consultant Gynaecologist, FFH & FUMC, Pakistan
²Resident Gynaecology and Obstetrics, FUMC, Pakistan
³House Officer, CMH, Pakistan

Corresponding Author: Shahida Akhtar, Professor and Consultant Gynaecologist, FFH & FUMC, Pakistan.

Received: May 16, 2015; Published: May 27, 2015

Citation: Shahida Akhtar., et al. “Frequency of Cervical Intraepithelial Neoplasia in the Patients Screened By Pap Smear at a Tertiary Care Setup”. EC Gynaecology 1.3 (2015): 100-102.

Abstract

Objective: To determine the frequency of Pap smear results in a sample of females presenting to the Gynaecology OPD of FFH Rawalpindi and to emphasize role of Cervical Cancer screening by Pap smear in reducing the incidence of Hysterectomy.

Study Design: Cross sectional study.

Duration and Setting: Our study was carried out from January to July 2014 in the Gynaecology and obstetrics department of FUMC and FFH Rawalpindi.

Materials and Methods: A sample of 222 patients presenting to the Gynaecology & obstetrics OPD with abnormal vaginal discharge and/or lower abdominal and pain were included in our study. These patients were screened using Pap smear test and the samples were sent to the Histopathology Dept of FFH Rwp. The results were analysed, frequency/percentages calculated and charts were plotted using Microsoft Excel software.

Results: Out of the 222 pap smears done, 182 (81.9%) revealed normal study, 23 (10%) chronic infection, 9 (4%) squamous intraepithelial lesion, 3 (1.35%) bacterial vaginosis while 5 (2.25%) smears were scanty. Among the 9 patients who screened positive for Squamous Intraepithelial Lesion, 7 were from post-menopausal age group whereas 2 were peri-menopausal.

Conclusion: The frequency of Cervical Intraepithelial Neoplasia in a sample of patients presenting to our tertiary care setup is 4%.

Keywords: Pap smear; CIN; SIL

Introduction

In developing countries, cervical cancer is the most common gynaecological cancer and one of the leading causes of cancer death [1]. Cervical cancers can be prevented through early detection and cervical smear is a sensitive test for it [2]. Prevention of cervical cancer has been intensively studied in order to reduce or eliminate the occurrence of this significant disease, which has a negative impact on population mortality and morbidity [3]. The ability to screen and treat women for preinvasive disease, cervical dysplasia, is the key factor leading to the reduction in the incidence of invasive cervical cancer [4].

Materials and Methods

Retrospective cross sectional survey was done from Jan 2014 to July 2014 on patients reporting to Gynaecology OPD FFH. Data was collected from cytology department where the pap smears of patients were reported. The data was analysed retrospectively, Pap smear was performed on all the patients who presented to Gynaecology OPD with complaints of chronic per vaginal discharge and lower abdominal pain, those who have normal looking cervix on visual inspection and those who do not have.

Results

Out of the 222 pap smears done, 182 (81.9%) revealed normal study, 23 (10%) chronic infection, 9 (4%) squamous intraepithelial lesion, 3 (1.35%) bacterial vaginosis while 5 (2.25%) smears were scanty. Among the 9 patients who screened positive for Squamous Intraepithelial Lesion, 7 were from post-menopausal age group whereas 2 were peri-menopausal. Our results are demonstrated in the tabulated and graphical form as follows.

Figure 1: Frequency and percentages of pap smear results.

	Normal pap smear	Squamous intraepithelial lesion	Chronic infection	Bacterial vaginosis	Scanty
Frequency	182	9	23	3	5
Percentage	81.9%	4%	10%	1.35%	2.25%

Table 1: Frequency and percentages of pap smear results.

Age	Menstrual Status	Cervical Findings
43	Peri menstrual	Normal looking
60	Post-menopausal	Cervix flushed with vagina
49	Post-menopausal	Normal looking
62	Post-menopausal	Cervix flushed with vagina haemorrhagic punctae on cervical lips
43	Peri menopausal	Normal looking
50	Post-menopausal	Unhealthy looking cervix
58	Post-menopausal	Unhealthy looking cervix
60	Post-menopausal	Unhealthy looking cervix
48	Post-menopausal	Cervix flushed with vagina

Table 2: Age, Menstrual status and cervical findings of SIL positive patients.

Discussion

Cervical cancer is 2^nd most common malignancy in sexually active females and 3^rd most common gynaecological malignancy causing death. Early detection of this malignancy can prevent the morbidity and mortality associated with cervical cancer. Pap smear is easy and cost effective method for screening of such patients. In our study all the patients who presented with abnormal PV discharge were undergone Pap smear. 4% of patients were positive for squamous intraepithelial lesions with mean age of 52 years. 3 patients had normal looking cervix. Rest of the patients had unhealthy cervix. Therefore besides having normal looking cervix patient should be screened for cervical malignancy especially those who present with vaginal discharge.

Conclusion

The frequency of Cervical Intra-epithelial Neoplasia in a sample of patients presenting to our tertiary care setup is 4%. Out of these, 3 patients had normal looking cervix. Rest of the patients had unhealthy cervix. Therefore there should be a high index of suspicion of cervical malignancy in patients with abnormal vaginal discharge even if they have a normal looking cervix.

Bibliography

Copyright: © 2015 Shahida Akhtar., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.