Abstract: Introduction and Background: Among women, cervical cancer is still one of the top causes of death and disability, especially in underdeveloped nations. The purpose of this research is to determine if cytological and histological results in women with a healthy cervix are correlated, and to evaluate the sensitivity and specificity of Pap screening and cervical biopsy in identifying cervical abnormalities.
Materials and Methods: A prospective observational study was conducted at Department of OBG, Fathima Institute of Medical Science, Ramarajupalli, Kadapa, Andhra Pradesh, India between December 2020 to November 2021, including 60 women aged 20-65 years presenting with clinically unhealthy cervix. The Bethesda system was used to classify the outcomes of the Pap smear screenings that all patients had. For histological evaluation, patients who had abnormal Pap tests or ongoing clinical suspicion underwent colposcopy-guided cervical biopsies. Data was statistically examined to determine the specificity, sensitivity, and association of Pap smear results with histopathology.
Results: In the study, out of 50 women, Pap smears detected inflammatory smears in 28%, ASC-US in 12%, LSIL in 16%, HSIL in 10%, SCC in 6%, and NILM in 28%. Histopathology confirmed chronic cervicitis in 40%, CIN (I, II, III) in 24%, invasive carcinoma in 6%, and benign cervical polyp in 10%. The sensitivity of Pap smear for detecting high-grade lesions was 78%, and its specificity was 85%. There was a significant correlation (p<0.05) between Pap smear and histopathology, confirming its role as a primary screening tool.
Conclusion: For the detection of cervical abnormalities, both precancerous and cancerous, pap smears are an invaluable, non-invasive, and cost-effective screening tool. Cases with aberrant cytology or persistent clinical suspicion, however, still require histological confirmation by biopsy. The study highlights the significance of regular cervical cancer screenings and the use of biopsies for final diagnosis in order to improve the outcomes of early detection and treatment.
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