To study Pap smear screening with follow up of all abnormal reports with colposcopy and biopsy.
Setting and design: This is a retrospective study conducted on 1980 patients to evaluate all previously conducted cervical smears of patients who attended the Obstetrics and Gynaecology outpatient department at the teaching tertiary care hospital during the period August 2014 to September 2017 for a period of 3 years. Pap smear is done in all OPD patients as a part of routine screening.
Materials and methodology: Pap smear is done in all OPD patients as a part of routine screening. We analysed all pap smears from August 2014 to September 2017 for a period of 3 years. The cytological interpretation of the smears was made according to Bethesda system. We also analysed subgroups of abnormal reports. Abnormal pap smears were subjected to colposcopy guided cervical biopsies for histopathological examination.
Results: Pap smear was taken in 1980 patients over a period of 3 years. Of the 1545 (78.9%) abnormal cases, only 136 cases were reported to have epithelial cell abnormality. The age range of patients with epithelial cell abnormality was 20 to 70 years and the mean age was 44.1 years. The diagnosis of the 136 abnormal cases revealed 13 cases with ASC-US, 106(5.3%) cases of LSIL, 14 (0.7%) of HSIL, 3(0.1%) cases of malignancy. 336(16.9%) smears were reported normal cases and 99 (5 %) smears were unsatisfactory or inadequate samples. A total of 64 had colposcopy abnormalities and required biopsy. Of which 3 were diagnosed of chronic cervicitis, 21 were CIN 1, 23 Were CIN II, 5 were CIN III, 12 cases were of frank malignancy, most common being squamous cell carcinoma 11 cases and adenocarcinoma in 1 case.
Conclusion: Pap smear is a noninvasive, simple procedure deserves to be implemented as a routine screening test in OPD. This has aided in early diagnosis of pre-malignancy and malignancy.Histopathological examination is correlating well with Pap smear and clinical presentation.