Pap Smear Evaluation through Opportunistic Screening Programme in Tertiary Care Hospitals and Rural Mangalore

Abstract

Introduction: Pap smear cytology enables the cytopathologist to detect and evaluate the degree of cellular alterations present in uterine cervical lesions. Cytopathological analysis of these smears has stood out amongst other tests because of its simplicity and low cost, which are essential characteristics of methods applicable to mass screening programmes. Aim: Opportunistic screening by using Pap smear examination from the uterine cervix of women attending out reach camps and outpatient department employing the Bethesda System 2014. To detect genital infections and epithelial cell abnormalities in symptomatic and asymptomatic women. Also to correlate the cytology of the lesions with histopathology, wherever available. Materials and Methods: Opportunistic screening programme has the advantage to screen women who attend outpatient department and outreach camps. The study included 3255 Pap smears of women received from the outpatient departments of AJ Institute of Medical Sciences and Research Centre, Mangalore, KMC Hospital, Mangalore and various outreach camps and private consultants of rural Mangalore, Karnataka over a period of three years. The smears were stained by Modified Papanicolaou stain and analyzed using the Bethesda system criteria (2014). Histopathological correlation was done wherever available. Results: Out of a total of 3255 pap smears, 626 (19.23%) were unsatisfactory, 2532 (77.78%) were Negative for Intraepithelial Lesion or Malignancy (NILM) and 97 (2.98%) showed epithelial cell abnormalities of which 23 (23.7%) showed malignancy. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of Pap smear cytology in the study were 80.49%, 92.23% , 67.35%, 95.96% and 90.28% respectively. Conclusion: Cervical smear cytology assists in the early detection of precancerous lesions of the cervix thereby down staging cervical neoplasias and also helps in the diagnosis of specific infections of the female genital tract.

Keywords

• cancer screening
• cervical cytology
• histopathology